Provider Demographics
NPI:1174506273
Name:PILEVSKY, NICOLE D (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:D
Last Name:PILEVSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:7625 MAPLE LAWN BOUELEVARD
Practice Address - Street 2:STE 1 LOWER LOBBY
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2565
Practice Address - Country:US
Practice Address - Phone:410-531-7557
Practice Address - Fax:410-531-0818
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0060751207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD404779600Medicaid
MD994LMedicare UPIN
MD404779600Medicaid