DR. MADHU SREEKANTH JASTI (NPI# 1114231545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114231545 |
| Entity Type | Individual |
| Full Name | DR. MADHU SREEKANTH JASTI |
| Credential | M.D |
| Practice Address |
203 Hospital Dr Ste 200 Glen Burnie MD 21061-6905 |
| Mailing Address |
920 Elkridge Landing Rd Linthicum MD 21090-2917 |
| Practice Telephone | 4105538160 |
| Practice Fax Number | 4105538159 |
| Mailing Telephone | 4434625010 |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2020-01-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
D82700 | MD | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MD454433 | PA | Allopathic & Osteopathic Physicians |
| N | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
D82700 | MD | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| One Medical Center Blvd, Acp, Suite 533, Upland, PA 190133902 | 6108741184 | 6108744258 |
| Street Address |
203 HOSPITAL DR STE 200 |
| City | GLEN BURNIE |
| State | MD |
| Zip Code | 21061-6905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053300962 | Larry Webster Blum | Psychiatry & Neurology | 203 Hospital Dr Ste 200, Glen Burnie, MD 21061-6905 | 2005-10-14 |
| 1396253555 | Johns Hopkins Regional Physicians LLC | Allergy & Immunology | 203 Hospital Dr Ste 200, Glen Burnie, MD 21061-6905 | 2018-01-22 |
| 1568704971 | Christopher Andrew Stack | Psychiatry & Neurology | 203 Hospital Dr Ste 200, Glen Burnie, MD 21061-6905 | 2013-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255814422 | Lotus Behavioral Health and Rehabilitation Services Inc. | Behavior Technician | 6426 Harrison Square, Glen Burnie, MD 21061 | 2018-09-12 |
| 1942795315 | Tina Brown | Behavior Technician | Rise for Autism, 510 Mccormick Drive, Ste. U-w, Glen Burnie, MD 21061 | 2018-06-27 |
| 1205351905 | Digna Emerita Sanchez De Vasquez | Specialist/Technologist, Other | 201 Fernglen Ave, Glen Burnie, MD 21061 | 2017-08-03 |
| 1255780300 | Rachel Cutts | Physical Therapist | 7711 Quarterfield Rd Ste C2, Glen Burnie, MD 21061 | 2016-06-09 |
| 1295181170 | Gaudenzia, Inc. | Counselor | 5 Crain Highway North - Rear Suite Entrance, Glen Burnie, MD 21061 | 2016-05-10 |
| 1023499548 | Mary Bourbon | Nurse Practitioner | 1600 S. Cain Highway, Suite 401, Glen Burnie, MD 21061 | 2015-06-10 |
| 1972997724 | Robert Oladeinde | Physician Assistant | 6934 Aviation Blvd Suite B, Glen Burnie, MD 21061 | 2015-03-18 |
| 1205248069 | Cathy Qing He | Anesthesiology | 1600 Crain Hwy S Ste 301, Glen Burnie, MD 21061 | 2014-05-28 |
| 1477974764 | Shannon Holder | Nurse Practitioner | 1916 Crain Hwy S Ste 2, Glen Burnie, MD 21061 | 2014-01-03 |
| 1629404207 | Marla Ann Muha | Physician Assistant | 301 Hospital Dr # 803, Glen Burnie, MD 21061 | 2013-09-16 |
| Find all providers in zip 21061 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316966179 | Sangjin Oh | Psychiatry & Neurology | 1412 Crain Hwy N Ste 6a, Glen Burnie, MD 21061 | 2006-07-19 |
| 1053300962 | Larry Webster Blum | Psychiatry & Neurology | 203 Hospital Dr Ste 200, Glen Burnie, MD 21061-6905 | 2005-10-14 |
| 1730745159 | Sangjin Oh Md Pa | Psychiatry & Neurology | 1412 Crain Hwy N Ste 6a, Glen Burnie, MD 21061-7000 | 2019-05-10 |
| 1083077499 | Spine & Sports Physical Therapy & Diagnostics, LLC | Psychiatry & Neurology | 1406b Crain Hwy S, Suite 107, Glen Burnie, MD 21061-4099 | 2016-04-02 |
| 1568704971 | Christopher Andrew Stack | Psychiatry & Neurology | 203 Hospital Dr Ste 200, Glen Burnie, MD 21061-6905 | 2013-03-24 |
| 1497064968 | Neuro Diagnostic Center Pa | Psychiatry & Neurology | 325 Hospital Dr Ste 104, Glen Burnie, MD 21061-5806 | 2010-10-01 |
| 1184881245 | Talat Qadeer Alvi | Psychiatry & Neurology | 325 Hospital Dr, Suite 106 Dughly and Associates, Glen Burnie, MD 21061-5860 | 2008-05-16 |
| 1427123124 | Muhammad Eyad Dughly | Psychiatry & Neurology | 325 Hospital Drive, Suite 106 Dughly & Associates Pa, Glen Burnie, MD 21061 | 2006-11-21 |
| 1851352942 | Samuel B Miller | Psychiatry & Neurology | 7310 Ritchie Hwy, Suite 710, Glen Burnie, MD 21061 | 2006-03-29 |
| 1316907892 | Harshad R Mody | Psychiatry & Neurology | 7310 Ritchie Hwy, Suite 710, Glen Burnie, MD 21061-3065 | 2006-03-27 |
| Find all providers in GLEN BURNIE | ||||
| City | GLEN BURNIE |
| Zip Code | 21061 |
Please comment or provide details below to improve the information on DR. MADHU SREEKANTH JASTI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.