MEDICARE: JHANSI LAKSHMI GAJJALA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	MD036368	DC

General Provider Information

NPI Number	:	1548437106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JHANSI LAKSHMI GAJJALA

Provider Business Mailing Address
First Line	:	408 OLD STONE RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-5958
Country	:	US
Telephone Number	:	301-879-6939
Fax Number	:

Provider Business Practice Location Address
First Line	:	2139 GEORGIA NWAVE 3RD
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20001-3035
Country	:	US
Telephone Number	:	202-865-7513
Fax Number	:	202-865-1037

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	10/26/2015

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