Healthcare Provider Details

I. General information

NPI: 1154231173
Provider Name (Legal Business Name): PANDA CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 WILLARD AVE # 17594257
CHEVY CHASE MD
20815-3690
US

IV. Provider business mailing address

9901 LINN STATION RD STE 500
LOUISVILLE KY
40223-3881
US

V. Phone/Fax

Practice location:
  • Phone: 502-785-9794
  • Fax:
Mailing address:
  • Phone: 502-785-9794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NISHI RAWAT
Title or Position: OWNER
Credential: MD
Phone: 502-785-9794