Provider Demographics
NPI:1649706193
Name:AGGARWAL, SOORYA NAMBOODIRI (DO)
Entity type:Individual
Prefix:DR
First Name:SOORYA
Middle Name:NAMBOODIRI
Last Name:AGGARWAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:SOORYA
Other - Middle Name:KRISHNAN
Other - Last Name:NAMBOODIRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10770 COLUMBIA PIKE STE 400
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4462
Mailing Address - Country:US
Mailing Address - Phone:215-589-9012
Mailing Address - Fax:
Practice Address - Street 1:15001 SHADY GROVE RD STE 300
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6353
Practice Address - Country:US
Practice Address - Phone:301-340-3252
Practice Address - Fax:301-340-1423
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT017722207R00000X
MDH0092882207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine