Provider Demographics
NPI:1225329956
Name:KANNAN AND ASSOCIATES PC
Entity Type:Organization
Organization Name:KANNAN AND ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIJAY SHRI
Authorized Official - Middle Name:
Authorized Official - Last Name:KANNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-681-7010
Mailing Address - Street 1:10301 GEORGIA AVE
Mailing Address - Street 2:203
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10301 GEORGIA AVE
Practice Address - Street 2:203
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5020
Practice Address - Country:US
Practice Address - Phone:301-681-7010
Practice Address - Fax:301-593-8366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2012-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD63183207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty