PAVAN KUMAR NOOTHETI M.D., FAAD
NPI 1912130287
Dermatology - MOHS-Micrographic Surgery in College Park, MD
- Individual
- Male
- Dermatology
- MOHS-Micrographic Surgery
About PAVAN NOOTHETI
This page provides the complete NPI Profile along with additional information for Pavan Nootheti, a provider established in College Park, Maryland with a medical specialization in Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1912130287 assigned on September 2009. The practitioner's primary taxonomy code is 207ND0101X with license number D73150 (MD). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1912130287 Verify this NPI
- Provider Name
- PAVAN KUMAR NOOTHETI M.D., FAAD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4700 BERWYN HOUSE RD SUITE 108 COLLEGE PARK, MD 20740
- Location Phone
- (858) 752-4459
- Mailing Address
- 1 STAPLEFORD HALL CT POTOMAC, MD 20854
- Mailing Phone
- (858) 752-4459
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-02-2009
- Last Update Date
- 01-05-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology MOHS-Micrographic Surgery
- Taxonomy Code
- 207ND0101X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- D73150
- License State
- MD
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | A90335 (CA) |
| 2 | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | D73150 (MD) |
| 3 | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | MD33040 (DC) |
| 4 | 207ND0101X | Allopathic & Osteopathic Physicians | Dermatology | A90335 (CA) |
| 5 | 207ND0101X | Allopathic & Osteopathic Physicians | Dermatology | MD33040 (DC) |
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Other Providers at the Same Location
The following 16 providers are registered at the same or a nearby location.
COLLEGE PARK, MD 20740
COLLEGE PARK, MD 20740
COLLEGE PARK, MD 20740
COLLEGE PARK, MD 20740
COLLEGE PARK, MD 20740
COLLEGE PARK, MD 20740
COLLEGE PARK, MD 20740
COLLEGE PARK, MD 20740
COLLEGE PARK, MD 20740
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912130287, enumerated as an "individual" on September 02, 2009.
The provider is located at 4700 BERWYN HOUSE RD SUITE 108 COLLEGE PARK, MD 20740 and the phone number is (858) 752-4459.
Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.
