Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 01408 | MD |
NPI | 1225099278 |
---|---|
Provider Name | Dr. Tatyana Abramova |
First Address | Pikesville, MD 21208-1956 |
Second Address | Baltimore, MD 21208-6114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 06/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
406074100 | (05) | MD |
V00797 | (02) | MD |