Basic Information
| Provider Information | |||||||||
| NPI: | 1548437106 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAJJALA | ||||||||
| FirstName: | JHANSI | ||||||||
| MiddleName: | LAKSHMI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 408 OLD STONE RD | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209045958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018796939 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2139 GEORGIA NWAVE 3RD | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200013035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028657513 | ||||||||
| FaxNumber: | 2028651037 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2008 | ||||||||
| LastUpdateDate: | 10/26/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | MD036368 | DC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.