Organization
KAVITHA K NAKKA, MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KISHORE K NAKKA (OFFICER)
(703) 435-1713
Entity
Organization
Contact information
Practice address
8301 ARLINGTON BLVD, SUITE # T-5, FAIRFAX, VA 22031-2902
(703) 560-0404
Mailing address
12601 WINTER WREN CT, OAK HILL, VA 20171-1830
(703) 560-0404
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
06068936
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010051291
—
VA
01
—
DC4838
RAILROAD MEDICARE PIN
—
Enumeration date
04/08/2008
Last updated
09/05/2013
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