Individual
SAGAR VIDYA NOOTHETI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4700 BERWYN HOUSE ROAD, SUITE 108, COLLEGE PARK, MD 20740-4706
(301) 345-0077
(301) 345-4489
Mailing address
4700 BERWYN HOUSE ROAD, SUITE 108, COLLEGE PARK, MD 20740-4706
(301) 345-0077
(301) 345-4489
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
D24694
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134251700
—
MD
01
—
146085200
DEPT OF LABOR
—
01
—
23222
AETNA
—
01
—
28320001
BC/FED
—
01
—
60054
AETNA
—
01
—
62308
CIGNA
—
01
—
6480SV
BC/MD
—
Enumeration date
08/25/2006
Last updated
07/27/2010
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