Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | DOO52322 | MD |
NPI | 1235178344 |
---|---|
Provider Name | Dr. Mikhail Gendel |
First Address | Gaithersburg, MD 20877-4039 |
Second Address | Gaithersburg, MD 20877-4039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 04/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G01944 | (02) | MD |