Provider Demographics
NPI:1447410220
Name:THOTA, DARSHAN SUBBARAO NAIDU (MD)
Entity Type:Individual
Prefix:DR
First Name:DARSHAN
Middle Name:SUBBARAO NAIDU
Last Name:THOTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:102 COLONY PL
Mailing Address - Street 2:
Mailing Address - City:SAINT SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-1103
Mailing Address - Country:US
Mailing Address - Phone:912-571-2842
Mailing Address - Fax:
Practice Address - Street 1:7700 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2929
Practice Address - Country:US
Practice Address - Phone:912-571-2842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-14
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA63228207P00000X, 2083C0008X
390200000X
CA110703207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program