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Organization

NEUROLOGY OFFICE, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
S KIRSHNA NANDIPATI MD (CEO)
(301) 843-2222
Entity
Organization

Contact information

Practice address
3500 OLD WASHINGTON RD, SUITE 202, WALDORF, MD 20602-3224
(301) 843-2222
(301) 934-9321
Mailing address
3500 OLD WASHINGTON RD, SUITE 202, WALDORF, MD 20602-3224
(301) 843-2222
(301) 934-9321

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D38160
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G939
BLUE CROSS
DC
Enumeration date
09/28/2007
Last updated
09/28/2007
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