Provider Demographics
NPI:1083773212
Name:LUSHNIAK, BORIS D (MD)
Entity Type:Individual
Prefix:DR
First Name:BORIS
Middle Name:D
Last Name:LUSHNIAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:15128 RED CLOVER DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1642
Mailing Address - Country:US
Mailing Address - Phone:301-827-0917
Mailing Address - Fax:301-827-5671
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:NNMC DEPT OF PROFESSIONAL AFFAIRS
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5600
Practice Address - Country:US
Practice Address - Phone:301-295-6231
Practice Address - Fax:301-295-5928
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35060049207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology