Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | D0059620 | MD |
NPI | 1033214853 |
---|---|
Provider Name | Slavka Assenova Vassilieva Minassian |
First Address | Bethesda, MD 20814-2448 |
Second Address | Bethesda, MD 20814-2448 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 12/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
237224 | ANTHEM BC/BS (01) | |
403294200 | (05) | MD |
H79211 | (02) | |
J136 002 | CAREFIRST BC/BS (01) | |
P-12018630 | MULTIPLAN (01) |