# SAGAR V.NOOTHETI,M.D.P.A

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NOOTHETI,SAGAR VIDYA,M.D
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1851690705
- **Legal business name:** NOOTHETI,SAGAR VIDYA,M.D
- **Authorized official:** MRS. ANITA RANDEV (OFFICE MANAGER)
- **Authorized official phone:** (301) 345-0077

## Contact information

- **Practice address:** 4700 BERWYN HOUSE RD, SUITE 108, COLLEGE PARK, MD 20740-2474
- **Practice address phone:** (301) 345-0077
- **Practice address fax:** (301) 345-4489
- **Mailing address:** 4700 BERWYN HOUSE RD, SUITE 108, COLLEGE PARK, MD 20740-2474
- **Mailing address phone:** (301) 345-0077
- **Mailing address fax:** (301) 345-4489

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | D24694 | MD | Yes |

## Other

- **Enumeration date:** 03/17/2011
- **Last updated:** 03/17/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1345251700 | — | MD |
| 01 | — | 146085200 | DEPT.OF LABOR | DC |
| 01 | — | 23222 | AETNA | MD |
| 01 | — | 28320001 | BC/FED | DC |
| 01 | — | 60054 | AETNA | MD |
| 01 | — | 62308 | CIGNA | MD |
| 01 | — | 6480SV | BC/MD | MD |