Provider Demographics
NPI:1174502132
Name:GONDI, APPAJI (MD)
Entity Type:Individual
Prefix:DR
First Name:APPAJI
Middle Name:
Last Name:GONDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 SPRING HILL RD
Mailing Address - Street 2:STE 350
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3006
Mailing Address - Country:US
Mailing Address - Phone:703-790-9722
Mailing Address - Fax:703-893-8666
Practice Address - Street 1:1420 SPRING HILL RD
Practice Address - Street 2:STE 350
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3006
Practice Address - Country:US
Practice Address - Phone:703-790-9722
Practice Address - Fax:703-893-8666
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240011207K00000X
DCMD036216207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1174502132Medicaid
DC020674Y78Medicare PIN
VA1174502132Medicaid