| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
Salih Grice, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 23 Crossroads Dr Ste 340, Owings Mills, MD 21117 Phone: 410-653-0366 Fax: 410-601-4759 | |
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 | |
Oludolapo Ilori, Family Medicine Medicare: Medicare Enrolled Practice Location: 23 Crossroads Dr Ste 340, Owings Mills, MD 21117 Phone: 410-653-0366 Fax: 410-601-4759 | |
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 |