Individual
DR. KRISHNAVENI CHEETHIRALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13900 LAUREL LAKES AVE, LAUREL, MD 20707-5091
(301) 498-1900
Mailing address
13900 LAUREL LAKES AVE STE 240, LAUREL, MD 20707-5023
(301) 498-1900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D72757
MD
208000000X
Pediatrics Physician
GETP.TUL.PED
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
223316900
—
MD
Enumeration date
05/16/2008
Last updated
11/02/2023
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