Provider Demographics
NPI:1801002449
Name:KALIDINDI, KAVITA R (MD)
Entity type:Individual
Prefix:
First Name:KAVITA
Middle Name:R
Last Name:KALIDINDI
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:PO BOX 37189
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3189
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:8100 ASHTON AVE STE 101
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-5647
Practice Address - Country:US
Practice Address - Phone:703-257-8090
Practice Address - Fax:703-257-7822
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246322207QA0505X, 207Q00000X
VA0100246322207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine