Provider Demographics
NPI:1801959390
Name:CHATTERGOON, MICHAEL ANAND (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANAND
Last Name:CHATTERGOON
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:1830 E MONUMENT ST
Mailing Address - Street 2:ROOM 402
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0020
Mailing Address - Country:US
Mailing Address - Phone:410-502-2326
Mailing Address - Fax:410-955-7889
Practice Address - Street 1:MOORE CLINIC CARNEGIE 346
Practice Address - Street 2:600 NORTH WOLFE STREET
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-1723
Practice Address - Fax:410-955-7733
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2013-12-05
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Provider Licenses
StateLicense IDTaxonomies
PAMT185736207R00000X
PAMD434052207R00000X
MDD71080207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD036284100Medicaid
MD036284100Medicaid