Healthcare Provider Details

I. General information

NPI: 1437345709
Provider Name (Legal Business Name): YAMINI VENKATA LAXMI SARIPALLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SEVEN LOCKS RD SUITE 111
ROCKVILLE MD
20854-2931
US

IV. Provider business mailing address

PO BOX 79632
BALTIMORE MD
21279-0632
US

V. Phone/Fax

Practice location:
  • Phone: 301-762-5020
  • Fax: 301-294-7569
Mailing address:
  • Phone: 301-762-5020
  • Fax: 301-309-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD036892
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberD63380
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number0101245220
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: