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General NPI Number Information
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NPI Number | 1851690705
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Entity Type | Organization
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Legal Business Name | SAGAR V.NOOTHETI,M.D.P.A
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Dates
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Enumeration Date | 03/17/2011
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Last Update Date | 03/17/2011
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Provider Practice Location Address
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Address Line | 4700 BERWYN HOUSE RD SUITE 108
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City | COLLEGE PARK
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State | MD
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Zip | 20740-2474
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Country | US
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Telephone | 301-345-0077
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Fax | 301-345-4489
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Provider Business Mailing Address
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Address Line | 4700 BERWYN HOUSE RD SUITE 108
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City | COLLEGE PARK
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State | MD
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Zip | 20740-2474
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Country | US
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Telephone | 301-345-0077
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Fax | 301-345-4489
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ANITA RANDEV
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Credential |
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Telephone | 301-345-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | D24694
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License Number State | MD
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