MEDICARE: AVINASH KASTURI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D0076555	MD

General Provider Information

NPI Number	:	1164729224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVINASH KASTURI M.D.

Provider Business Mailing Address
First Line	:	8816 JERICHO CITY DR
Second Line	:
City	:	NORTH ENGLEWOOD
State	:	MD
Zip	:	20785-4762
Country	:	US
Telephone Number	:	703-674-9990
Fax Number	:

Provider Business Practice Location Address
First Line	:	8816 JERICHO CITY DR
Second Line	:
City	:	NORTH ENGLEWOOD
State	:	MD
Zip	:	20785-4762
Country	:	US
Telephone Number	:	703-674-9990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2011
Last Update Date	:	08/04/2023

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