1. Home
  2. Directory
  3. Maryland
  4. College Park
  5. Dermatology
  6. NPI Profile

PAVAN KUMAR NOOTHETI M.D., FAAD
NPI 1912130287
Dermatology - MOHS-Micrographic Surgery in College Park, MD

Active since September 02, 2009
4700 BERWYN HOUSE RD, SUITE 108, COLLEGE PARK, MD 20740(858) 752-4459 Get Directions Write a Review

NPPES record last updated: January 5, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pavan Kumar Nootheti M.d., Faad NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PAVAN KUMAR NOOTHETI M.D., FAAD (NPI 1912130287) is an individual mohs-micrographic surgery provider in College Park, Maryland, licensed in Maryland (D73150) and active in the NPI registry since September 2009.

NPPES Registry Identity

NPI1912130287
Entity TypeIndividualMale
Primary Taxonomy207ND0101X
Provider Legal NamePAVAN KUMAR NOOTHETICredential: M.D., FAAD
Location Address4700 BERWYN HOUSE RD, SUITE 108College Park, MD 20740-2474
Mailing Address1 Stapleford Hall CtPotomac, MD 20854-4451 · (858) 752-4459
Phone(858) 752-4459
Sole ProprietorNo
Enumeration DateSeptember 2, 2009
Last NPPES UpdateJanuary 5, 2012
✔ NPI 1912130287 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Licenses✔ Licensed in MD · D73150✔ Licensed in CA · A90335✔ Licensed in DC · MD33040
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Also ListedDermatologyTaxonomy 207N00000X · License A90335 (CA), D73150 (MD), MD33040 (DC)
4700 BERWYN HOUSE RD, College Park, MD 20740
Open in Google Maps ↗

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANUJA GUPTA KURICHH MD
Internal Medicine
4700 BERWYN HOUSE RD, SUITE 105
COLLEGE PARK, MD 20740
Prince George's County (301) 982-0011
ASIF S QADRI M.D. P.A. GROUP
Internal Medicine
4700 BERWYN HOUSE RD, SUITE 100
COLLEGE PARK, MD 20740
Prince George's County (301) 474-3232
CAPITAL AREA PRIMARY CARE LLC
Internal Medicine
4700 BERWYN HOUSE RD, SUITE 108
COLLEGE PARK, MD 20740
Prince George's County (301) 679-6011
CHARLES EDWARD BUCKLEY MD
Radiology (Nuclear Radiology)
4700 BERWYN HOUSE RD, SUITE 102
COLLEGE PARK, MD 20740
Prince George's County (301) 345-0406
THERAPEUTIC WELLNESS, LLC
Community/Behavioral Health
4700 BERWYN HOUSE RD, SUITE 202
COLLEGE PARK, MD 20740
Prince George's County (301) 257-0894
GREATER WASHINGTON SKIN CENTER, LLC
Dermatology
4700 BERWYN HOUSE RD, SUITE 108
COLLEGE PARK, MD 20740
Prince George's County (858) 752-4459
MEDSTAR MEDICAL GROUP II LLC
General Practice
4700 BERWYN HOUSE RD
COLLEGE PARK, MD 20740
Prince George's County (706) 558-1403
MID-ATLANTIC CHILDREN'S SERVICES, INC
Psychologist (Clinical)
4700 BERWYN HOUSE RD, SUITE 206
COLLEGE PARK, MD 20740
Prince George's County (240) 297-9857

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pavan Nootheti's NPI number?

The NPI number for Pavan Nootheti is 1912130287. It was assigned to this individual provider in the NPPES registry on September 2, 2009.

Where is Pavan Nootheti located?

Pavan Nootheti practices at 4700 Berwyn House Rd Suite 108, College Park, MD 20740. The listed phone number is (858) 752-4459.

What is Pavan Nootheti's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

When was this NPI record last updated?

The NPPES record for Pavan Nootheti was last updated on January 5, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.