Venkata Laavanya Divakaruni, MD | |
10085 Red Run Blvd Ste 105, Owings Mills, MD 21117-4811 | |
(410) 581-7804 | |
Not Available |
Full Name | Venkata Laavanya Divakaruni |
---|---|
Gender | Female |
Speciality | Family Medicine |
Location | 10085 Red Run Blvd Ste 105, Owings Mills, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801425905 | NPI | - | NPPES |
221376100 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | D98286 (Maryland) | Primary |
Entity Name | Greater Baltimore Medical Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891855763 PECOS PAC ID: 1759276975 Enrollment ID: O20040217000852 |
Mailing Address | Practice Location Address |
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Venkata Laavanya Divakaruni, MD 10085 Red Run Blvd Ste 105, Owings Mills, MD 21117-4811 Ph: (410) 581-7804 | Venkata Laavanya Divakaruni, MD 10085 Red Run Blvd Ste 105, Owings Mills, MD 21117-4811 Ph: (410) 581-7804 |
Irene Lucy Atieno Olonde, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10210 Reisterstown Rd, Owings Mills, MD 21117 Phone: 410-902-6776 | |
Dr. Tammi Dawn Davis, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 9199 Reisterstown Rd, Suite 203b, Owings Mills, MD 21117 Phone: 419-591-3406 Fax: 410-902-1933 | |
Neka Doris Anyaogu, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10210 Reisterstown Rd, Owings Mills, MD 21117 Phone: 410-902-6776 | |
Danielle Azadeh Vaziri, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10210 Reisterstown Rd, Owings Mills, MD 21117 Phone: 410-902-6776 Fax: 410-902-6936 | |
Tamischer B. Nettles, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10210 Reisterstown Rd, Owings Mills, MD 21117 Phone: 410-902-6776 | |
Miss Zion Gibbs, FNP-BC Family Medicine Medicare: Medicare Enrolled Practice Location: 7920 Mcdonogh Rd Ste 201, Owings Mills, MD 21117 Phone: 855-527-7246 Fax: 866-229-5063 | |
Dr. Jason Kyle Federline, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10210 Reisterstown Rd, Owings Mills, MD 21117 Phone: 410-902-6776 |