Provider Demographics
NPI:1528301306
Name:DESIRAJU, SUNEETHA (MD)
Entity type:Individual
Prefix:
First Name:SUNEETHA
Middle Name:
Last Name:DESIRAJU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:
Practice Address - Street 1:4940 EASTERN AVE BLDG AA2
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-4224
Practice Address - Fax:410-550-1163
Is Sole Proprietor?:No
Enumeration Date:2013-03-31
Last Update Date:2019-09-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD874072080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine