Provider Demographics
NPI:1952697773
Name:KASI, SUNDEEP K (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNDEEP
Middle Name:K
Last Name:KASI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7501 GREENWAY CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3514
Mailing Address - Country:US
Mailing Address - Phone:301-474-4679
Mailing Address - Fax:301-474-7182
Practice Address - Street 1:6354 WALKER LN FL 1
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3229
Practice Address - Country:US
Practice Address - Phone:703-313-7421
Practice Address - Fax:703-313-9422
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD045044207W00000X, 207WX0107X
PAMD453961207W00000X
VA0101262441207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1952697773Medicaid
VA1952697773Medicaid