Prashanth A Mally, MD | |
12255 Fair Lakes Pkwy, Fairfax, VA 22033-3952 | |
(703) 934-5700 | |
Not Available |
Full Name | Prashanth A Mally |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Experience | 21 Years |
Location | 12255 Fair Lakes Pkwy, Fairfax, Virginia |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669649729 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207LP2900X | Anesthesiology - Pain Medicine | 101244719 (Virginia) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Kaiser Foundation Health Plan Of The Mid-atlantic States, Inc | 3779495858 | 1628 |
Entity Name | Kaiser Foundation Health Plan Of The Mid-atlantic States, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952461816 PECOS PAC ID: 3779495858 Enrollment ID: O20040105000308 |
Mailing Address | Practice Location Address |
---|---|
Prashanth A Mally, MD 2101 E Jefferson St, Kaiser Permanente Medicare Enrollment, Rockville, MD 20852-4908 Ph: (301) 816-2424 | Prashanth A Mally, MD 12255 Fair Lakes Pkwy, Fairfax, VA 22033-3952 Ph: (703) 934-5700 |
Mrs. Gloria Gilbert Black, CRNA Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 3600 Joseph Siewick Dr, Fairfax, VA 22033 Phone: 703-295-9360 Fax: 703-295-9369 | |
Barry Burureser Mcconville, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 10730 Main Street, Fairfax, VA 22030 Phone: 301-317-0020 Fax: 301-317-0028 | |
Hang Jin Yoon, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 10734 Main Street, Fairfax, VA 22030 Phone: 301-317-0020 Fax: 301-317-0028 | |
Nancy R Couleman, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 8501 Arlington Blvd, Suite 550, Fairfax, VA 22031 Phone: 703-573-2363 Fax: 703-573-7609 | |
Sang Joong Jeon, MEDICAL DOCTOR Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 10730 Main Street, Fairfax, VA 22030 Phone: 301-317-0020 Fax: 301-317-0028 | |
Dr. Kaadze M Wright, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 3600 Joseph Siewick Dr, Fairfax, VA 22033 Phone: 703-295-9360 Fax: 703-295-9369 | |
Dr. Jai K Lee, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 3600 Joseph Siewick Dr, Fairfax, VA 22033 Phone: 703-391-3129 Fax: 703-295-9369 |