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General NPI Number Information
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NPI Number | 1619416757
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Entity Type | Organization
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Legal Business Name | RAMINENI MD LLC
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 2440 M ST NW SUITE 200
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City | WASHINGTON
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State | DC
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Zip | 20037-1404
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Country | US
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Telephone | 202-288-0285
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Fax | 202-785-1370
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Provider Business Mailing Address
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Address Line | 6537 SOTHORON RD
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City | MC LEAN
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State | VA
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Zip | 22101-3022
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Country | US
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Telephone | 202-288-0285
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Fax | 202-785-4187
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. PRAFUL RAMINENI
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Credential | MD
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Telephone | 202-288-0285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD036474
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License Number State | DC
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