Provider Demographics
NPI:1972898625
Name:NAINI, PRATHAP R (MD)
Entity type:Individual
Prefix:DR
First Name:PRATHAP
Middle Name:R
Last Name:NAINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:26005 RIDGE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-1899
Mailing Address - Country:US
Mailing Address - Phone:301-414-2300
Mailing Address - Fax:301-414-0476
Practice Address - Street 1:7620 CARROLL AVE STE 201
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6388
Practice Address - Country:US
Practice Address - Phone:301-891-6647
Practice Address - Fax:301-891-6654
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD043099207V00000X
PAMT 199329390200000X
MDD0079635207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD101828100Medicaid