Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | D87243 | MD |
N | 111NI0900X | Internist | D87243 | MD |
Y | 207RG0100X | Gastroenterologist | D87243 | MD |
NPI | 1033472071 |
---|---|
Provider Name | Dr. Zurabi Lominadze |
First Address | Baltimore, MD 21264-4442 |
Second Address | Baltimore, MD 21201-1590 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2012 |
Last Update Date | 01/08/2019 |