Pavan Kumar Nootheti, MD, FAAD - Dermatology in College Park, MD

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Pavan Kumar Nootheti, MD, FAAD is a Dermatology - Mohs-micrographic Surgery physician based in College Park, Maryland. Pavan Kumar Nootheti is licensed to practice in Maryland (license number D73150) and his current practice location is 4700 Berwyn House Rd, Suite 108, College Park, Maryland. He can be reached at his office (for appointments etc.) via phone at (858) 752-4459.

NPI number for Pavan Kumar Nootheti is 1912130287 and his current mailing address is 1 Stapleford Hall Ct, Potomac, Maryland. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1912130287.

Contact Information

Pavan Kumar Nootheti, MD, FAAD
4700 Berwyn House Rd, Suite 108,
College Park, MD 20740-2474
(858) 752-4459
Not Available

Map and Direction




Physician's Profile

Full NamePavan Kumar Nootheti
GenderMale
SpecialityDermatology - Mohs-micrographic Surgery
Location4700 Berwyn House Rd, College Park, Maryland
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1912130287
  • Provider Enumeration Date: 09/02/2009
  • Last Update Date: 01/05/2012

Medical Identifiers

Medical identifiers for Pavan Kumar Nootheti such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1912130287NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207N00000XDermatology A90335 (California)Secondary
207ND0101XDermatology - Mohs-micrographic Surgery A90335 (California)Secondary
207ND0101XDermatology - Mohs-micrographic Surgery D73150 (Maryland)Primary
207N00000XDermatology D73150 (Maryland)Secondary
207N00000XDermatology MD33040 (District Of Columbia)Secondary
207ND0101XDermatology - Mohs-micrographic Surgery MD33040 (District Of Columbia)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Pavan Kumar Nootheti is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Pavan Kumar Nootheti, MD, FAAD
1 Stapleford Hall Ct,
Potomac, MD 20854-4451

Ph: (858) 752-4459		Pavan Kumar Nootheti, MD, FAAD
4700 Berwyn House Rd, Suite 108,
College Park, MD 20740-2474

Ph: (858) 752-4459

Reviews and Comments


Dermatology Doctors in College Park, MD


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