Provider Demographics
NPI:1801184759
Name:MARELLA, LAKSHMI LAVANYA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAKSHMI
Middle Name:LAVANYA
Last Name:MARELLA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6710 OXON HILL RD STE 200B
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1124
Mailing Address - Country:US
Mailing Address - Phone:301-373-7900
Mailing Address - Fax:301-373-6900
Practice Address - Street 1:6710 OXON HILL RD STE 200B
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1124
Practice Address - Country:US
Practice Address - Phone:301-373-7900
Practice Address - Fax:301-373-6900
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0078205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD512411500Medicaid
MD512411500Medicaid