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General NPI Number Information
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NPI Number | 1407886336
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Entity Type | Individual
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Provider Name | NANDAKUMAR B VELLANKI MD
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Gender | Male
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 11/14/2017
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Provider Practice Location Address
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Address Line | 8850 COLUMBIA 100 PKWY STE 301
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City | COLUMBIA
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State | MD
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Zip | 21045-2377
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Country | US
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Telephone | 301-560-4747
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Fax | 301-776-1725
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Provider Business Mailing Address
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Address Line | 7350 VAN DUSEN RD STE 130
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City | LAUREL
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State | MD
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Zip | 20707-5267
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Country | US
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Telephone | 301-560-4747
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Fax | 301-776-1725
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | D30469
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License Number State | MD
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