Provider Demographics
NPI:1023010394
Name:TCHOPEV, NIKOLAY Z (MD)
Entity Type:Individual
Prefix:
First Name:NIKOLAY
Middle Name:Z
Last Name:TCHOPEV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5328 DUNTEACHIN DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-8204
Mailing Address - Country:US
Mailing Address - Phone:410-350-1090
Mailing Address - Fax:855-543-4914
Practice Address - Street 1:5328 DUNTEACHIN DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-8204
Practice Address - Country:US
Practice Address - Phone:410-350-1090
Practice Address - Fax:855-543-4914
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2014-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0065507207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4726012Medicaid
MI4726012Medicaid
MD4726012Medicaid