Individual
LAVANYA NUTANKALVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1860 TOWN CENTER DR STE 310, RESTON, VA 20190-5899
(703) 738-9989
(703) 738-9991
Mailing address
4437 BROOKFIELD CORPORATE DR STE 101, CHANTILLY, VA 20151-2122
(703) 738-9989
(703) 738-9991
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
01077934
IN
207RI0200X
Infectious Disease Physician
MD034555
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010176531
—
VA
05
—
036829400
—
DC
05
—
408044100
—
MD
Enumeration date
10/17/2006
Last updated
07/10/2023
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