Basic Information
| Provider Information | |||||||||
| NPI: | 1104910645 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAHATA | ||||||||
| FirstName: | APARAJITA | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD F.A.C.O.G. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 HOSPITAL RD STE 203 | ||||||||
| Address2: | |||||||||
| City: | PRINCE FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206784045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104144740 | ||||||||
| FaxNumber: | 4104144741 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 HOSPITAL RD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | PRINCE FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206784019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104144740 | ||||||||
| FaxNumber: | 4104144741 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 03/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | D38940 | MD | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 068850900 | 05 | MD | MEDICAID |