Healthcare Provider Details

I. General information

NPI: 1376726422
Provider Name (Legal Business Name): NATALLIA SHOTASHVILI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8455 COLESVILLE RD STE 1125
SILVER SPRING MD
20910-6397
US

IV. Provider business mailing address

15825 SHADY GROVE RD SUITE 140
ROCKVILLE MD
20850-4008
US

V. Phone/Fax

Practice location:
  • Phone: 301-615-8282
  • Fax:
Mailing address:
  • Phone: 301-869-9776
  • Fax: 301-216-2592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number000000
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: