Organization
PROFESSIONAL DERMATOLOGY CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAITHILY NANDEDKAR M.D. (OWNER)
(703) 860-1818
Entity
Organization
Contact information
Practice address
1801 ROBERT FULTON DR, SUITE 520, RESTON, VA 20191-5461
(703) 860-1818
(703) 860-5303
Mailing address
1801 ROBERT FULTON DR, SUITE 520, RESTON, VA 20191-5461
(703) 860-1818
(703) 860-5303
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101232644
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558319319
INDIVIDUAL NPI NUMBER FOR MAITHILY A. NANDEDKAR
VA
Enumeration date
08/11/2006
Last updated
01/03/2012
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