Provider Demographics
NPI:1033214853
Name:MINASSIAN, SLAVKA ASSENOVA VASSILIEVA (MD)
Entity Type:Individual
Prefix:
First Name:SLAVKA
Middle Name:ASSENOVA VASSILIEVA
Last Name:MINASSIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:7984 OLD GEORGETOWN RD
Mailing Address - Street 2:SUITE 7C
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2448
Mailing Address - Country:US
Mailing Address - Phone:301-654-4948
Mailing Address - Fax:301-654-0770
Practice Address - Street 1:7984 OLD GEORGETOWN RD
Practice Address - Street 2:SUITE 7C
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2448
Practice Address - Country:US
Practice Address - Phone:301-654-4948
Practice Address - Fax:301-654-0770
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2014-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0059620208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
J136 002OtherCAREFIRST BC/BS
237224OtherANTHEM BC/BS
P-12018630OtherMULTIPLAN
MD403294200Medicaid
MD403294200Medicaid
H79211Medicare UPIN