Provider Demographics
NPI:1356536700
Name:NOOTHETI, SAILAJA (MD)
Entity type:Individual
Prefix:DR
First Name:SAILAJA
Middle Name:
Last Name:NOOTHETI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 DIAMOND DR STE B
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5857
Mailing Address - Country:US
Mailing Address - Phone:301-790-1482
Mailing Address - Fax:301-790-1377
Practice Address - Street 1:1125 DIAMOND DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5857
Practice Address - Country:US
Practice Address - Phone:301-790-1482
Practice Address - Fax:301-790-1377
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058338207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology