Provider Demographics
NPI:1215340187
Name:PAMPATI, SNEHA (MD)
Entity type:Individual
Prefix:DR
First Name:SNEHA
Middle Name:
Last Name:PAMPATI
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 1:13900 LAUREL LAKES AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5023
Mailing Address - Country:US
Mailing Address - Phone:301-498-1900
Mailing Address - Fax:301-497-9885
Practice Address - Street 1:13900 LAUREL LAKES AVE STE 240
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5023
Practice Address - Country:US
Practice Address - Phone:301-498-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-08
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY50442208000000X
MDD0086382208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics