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Individual

DR. VLADIMIR KAKITELASHVILI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 CENTENNIAL ST, SUITE E, LA PLATA, MD 20646-5975
(301) 392-0525
(301) 392-0458
Mailing address
900 ELKRIDGE LANDING RD, LINTHICUM, MD 21090-2924
(301) 609-4695
(301) 392-0458

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
D0057225
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1095167
AETNA HMO/POS
MD
01
1552286
CIGNA
MD
01
2249341
UNITED HC/AMERICHOICE
MD
05
510328200
MD
01
610737600
FED WORKERS COMP - OWCP
01
616119-04
CARE FIRST BC/BS
MD
01
7801404
AETNA ELECT CHOICE
MD
01
827840
JOHNS HOPKINS GROUP #
MD
01
85484
AMERIGROUP
MD
Enumeration date
06/21/2005
Last updated
03/20/2025
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