Individual
PAVAN KUMAR NOOTHETI
Active
Individual
PAVAN KUMAR NOOTHETI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., FAAD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A90335
CA
207N00000X
Dermatology Physician
D73150
MD
207N00000X
Dermatology Physician
MD33040
DC
207ND0101X
MOHS-Micrographic Surgery Physician
A90335
CA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
D73150
MD
207ND0101X
MOHS-Micrographic Surgery Physician
MD33040
DC
Other
Enumeration date
09/02/2009
Last updated
01/05/2012
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