Provider Demographics
NPI:1710948807
Name:MINASSIAN, ANTON ANTRANIK (MD)
Entity Type:Individual
Prefix:
First Name:ANTON
Middle Name:ANTRANIK
Last Name:MINASSIAN
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 1:7984 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:
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:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0051046208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD12286799OtherMULTIPLAN
MD01033826OtherAMERIGROUP
MD533710100Medicaid
MD2117689OtherALLIANCE PPO
DCKFU7AAOtherCAREFIRST BC/BS
VA176020OtherANTHEM BC/BS
MD623782OtherUNICARE
608451900OtherWORKERS COMP/DEPT OF LABO
MDJ136 0001OtherCAREFIRST BC/BS
MD12286799OtherMULTIPLAN
VA176020OtherANTHEM BC/BS
608451900OtherWORKERS COMP/DEPT OF LABO