PAVAN KUMAR NOOTHETI M.D. FAAD NPI 1912130287

NPI Information

  • NPI: 1912130287
  • Provider Name: PAVAN KUMAR NOOTHETI, M.D., FAAD
  • Classification: Dermatology - 207ND0101X
  • Specialization: MOHS-Micrographic Surgery
  • Entity Type: Individual
  • Address: 4700 BERWYN HOUSE RD
    SUITE 108
    COLLEGE PARK, MD
    ZIP 20740
  • Phone: (858) 752-4459

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NPI Details

Pavan Kumar Nootheti, M.D., FAAD is a mohs-micrographic surgery dermatology in College Park, MD. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. Pavan Kumar Nootheti, M.D., FAAD NPI is 1912130287. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4700 BERWYN HOUSE RD
SUITE 108
COLLEGE PARK, MD
ZIP 20740-474
Phone: (858) 752-4459

The enumeration date for this NPI number is 9/2/2009 and was last updated on 1/5/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207N00000XDermatologyA90335CALIFORNIANo
2207ND0101XDermatologyMOHS-Micrographic SurgeryA90335CALIFORNIANo
3207N00000XDermatologyD73150MARYLANDNo
4207N00000XDermatologyMD33040DISTRICT OF COLUMBIANo
5207ND0101XDermatologyMOHS-Micrographic SurgeryMD33040DISTRICT OF COLUMBIANo
6207ND0101XDermatologyMOHS-Micrographic SurgeryD73150MARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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