Provider Demographics
NPI:1063455624
Name:HUGHES, KALPANA KODALI (MD)
Entity type:Individual
Prefix:DR
First Name:KALPANA
Middle Name:KODALI
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KALPANA
Other - Middle Name:KODALI
Other - Last Name:MURTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2700 QUARRY LAKE DR STE 270
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3744
Mailing Address - Country:US
Mailing Address - Phone:410-601-8663
Mailing Address - Fax:410-585-2852
Practice Address - Street 1:2700 QUARRY LAKE DR STE 270
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3744
Practice Address - Country:US
Practice Address - Phone:410-601-8663
Practice Address - Fax:410-585-2856
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD255842080P0206X
MDD436142080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD370006608OtherR/R MEDICARE PROVIDER #
MD850371100Medicaid