Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0101240011 | VA |
N | 207K00000X | Allergist & Immunologist | MD036216 | DC |
NPI | 1174502132 |
---|---|
Provider Name | Dr. Appaji Gondi |
First Address | Mc Lean, VA 22102-3006 |
Second Address | Mc Lean, VA 22102-3006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 28/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1174502132 | (05) | VA |