Provider Demographics
NPI:1649041179
Name:DMV ALLERGY AND ASTHMA CENTER LLC
Entity type:Organization
Organization Name:DMV ALLERGY AND ASTHMA CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NATARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-994-6655
Mailing Address - Street 1:10000 ORMOND RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-5028
Mailing Address - Country:US
Mailing Address - Phone:703-994-6655
Mailing Address - Fax:571-291-2752
Practice Address - Street 1:602 S ATWOOD RD STE 207A
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4172
Practice Address - Country:US
Practice Address - Phone:703-994-6655
Practice Address - Fax:571-291-2752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty