Provider Demographics
NPI:1487187803
Name:KANTAMNENI, HARIKA (DO)
Entity type:Individual
Prefix:
First Name:HARIKA
Middle Name:
Last Name:KANTAMNENI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22505 LANDMARK CT STE 210B
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-6500
Mailing Address - Country:US
Mailing Address - Phone:571-612-6350
Mailing Address - Fax:
Practice Address - Street 1:22505 LANDMARK CT STE 210B
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-6500
Practice Address - Country:US
Practice Address - Phone:571-612-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS021376207V00000X
VA0102208052207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology