GREATER WASHINGTON SKIN CENTER, LLC (NPI# 1245509439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245509439 |
| Entity Type | Organization |
| Organization Name | GREATER WASHINGTON SKIN CENTER, LLC |
| Practice Address |
4700 Berwyn House Rd Suite 108 College Park MD 20740-2474 |
| Practice Telephone | 8587524459 |
| Mailing Telephone | 8587524459 |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2011-12-19 |
| Authorized Official Name | DR. PAVAN KUMAR NOOTHETI (OWNER) |
| Authorized Official Telephone | 8587524459 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | DO073150 | MD | Allopathic & Osteopathic Physicians |
| Street Address |
4700 BERWYN HOUSE RD SUITE 108 |
| City | COLLEGE PARK |
| State | MD |
| Zip Code | 20740-2474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134128051 | Charles Edward Buckley | Radiology | 4700 Berwyn House Rd, Suite 102, College Park, MD 20740-2474 | 2005-07-21 |
| 1437595410 | Mid-atlantic Psychological Services | Psychologist | 4700 Berwyn House Rd, College Park, MD 20740-2474 | 2013-05-16 |
| 1356787527 | Mid-atlantic Children's Services, Inc | Psychologist | 4700 Berwyn House Rd, Suite 206, College Park, MD 20740-2474 | 2013-05-15 |
| 1083959175 | Capital Area Primary Care LLC | Internal Medicine | 4700 Berwyn House Rd, Suite 108, College Park, MD 20740-4706 | 2012-11-30 |
| 1851690705 | Sagar V.nootheti,m.d.p.a | Orthopaedic Surgery | 4700 Berwyn House Rd, Suite 108, College Park, MD 20740-2474 | 2011-03-17 |
| 1912130287 | Pavan Kumar Nootheti | Dermatology | 4700 Berwyn House Rd, Suite 108, College Park, MD 20740-2474 | 2009-09-02 |
| 1962669804 | Phc Healthcare LLC | Internal Medicine | 4700 Berwyn House Rd, Suite 105, College Park, MD 20740-2474 | 2008-05-19 |
| 1225218894 | Therapeutic Wellness, LLC | Community/Behavioral Health | 4700 Berwyn House Rd, Suite 202, College Park, MD 20740-2474 | 2007-11-12 |
| 1023228947 | Anuja Gupta Kurichh | Internal Medicine | 4700 Berwyn House Rd, Suite 105, College Park, MD 20740-2474 | 2007-05-22 |
| 1760602874 | Jonita Conner | Internal Medicine | 4700 Berwyn House Rd, College Park, MD 20740 | 2007-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073147633 | S.a.f.e. Counseling Services LLC | Counselor | 6210 Greenbelt Road, L 4, Berwyn Heights, MD 20740 | 2020-02-23 |
| 1326528621 | Ryan Rehabilitation LLC | Counselor | 7100 Baltimore Ave Ste 105, College Park, MD 20740 | 2018-08-16 |
| 1760981120 | L. Jones-dove & Associates Tooth Spa LLC | Dentist | 6103 Greenbelt Road, College Park, MD 20740 | 2018-02-12 |
| 1538682257 | Heather Gambacorto | Behavior Technician | 3525 Marlbrough Way, College Park, MD 20740 | 2017-07-25 |
| 1841722691 | Bradley Weitzel | Specialist/Technologist | 4068 Field House Drive, College Park, MD 20740 | 2017-03-31 |
| 1083152284 | Kabrima Y Petty | Nurse Practitioner | 10201 Baltimore Ave Apt 5102, College Park, MD 20740 | 2017-02-08 |
| 1659728517 | Brownstone Project In Md | Community/Behavioral Health | 6201 Greenbelt Rd Ste M6, Berwyn Heights, MD 20740 | 2016-05-20 |
| 1114371093 | Thomas Lowell Bennett | Specialist/Technologist | 7675 Baltimore Ave, R 0100, College Park, MD 20740 | 2016-04-18 |
| 1306226808 | Linda Ronma Williams | Nurse Practitioner | 4701 Melbourne Place, College Park, MD 20740 | 2015-06-01 |
| 1124427927 | Sarah Elizabeth Woerner | Pharmacist | 7300 Baltimore Boulevard, College Park, MD 20740 | 2014-08-18 |
| Find all providers in zip 20740 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912130287 | Pavan Kumar Nootheti | Dermatology | 4700 Berwyn House Rd, Suite 108, College Park, MD 20740-2474 | 2009-09-02 |
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|---|---|---|---|---|
| 1336748508 | Mana Dermatology LLC | Dermatology | 7500 Greenway Center Dr Ste 1220, Greenbelt, MD 20770-3502 | 2020-10-20 |
| 1922615509 | Dr. G Laser and Med Spa LLC | Dermatology | 11089 Resort Rd, Ellicott City, MD 21042-2073 | 2020-09-28 |
| 1669099321 | Consonant Healing Associates of De LLC | Dermatology | 909 Ridgebrook Rd Ste 220, Sparks, MD 21152-9476 | 2020-06-29 |
| 1366074023 | Consonant Healing, LLC | Dermatology | 1370 Lamberton Dr Ste 16, Silver Spring, MD 20902-3422 | 2020-02-10 |
| 1366900235 | Sarah Herdeman | Dermatology | 173 Saint Patricks Dr Ste 201, Waldorf, MD 20603-5531 | 2019-03-08 |
| 1710450408 | Givonshy Smith | Dermatology | 10478 Campus Way S # 185, Upper Marlboro, MD 20774-1304 | 2019-01-06 |
| 1679040208 | Ebony Nelson | Dermatology | 6031 Liberty Rd, Gwynn Oak, MD 21207-6206 | 2018-11-01 |
| 1184129975 | Swetcha Lankapalli | Dermatology | 45 Thomas Johnson Dr Ste 209, Frederick, MD 21702-4490 | 2018-03-26 |
| 1033659164 | Eternal Dermatology and Aesthetic Center LLC | Dermatology | 12150 Annapolis Rd Ste 213, Glenn Dale, MD 20769 | 2017-03-08 |
| 1598111254 | Alyssa Klein | Dermatology | 1447 York Rd Ste 301, Lutherville Timonium, MD 21093-6022 | 2016-05-11 |
| Find all providers with the same taxonomy | ||||
| City | COLLEGE PARK |
| Zip Code | 20740 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.