Provider Demographics
NPI:1952613424
Name:TRILISKY, IGOR (MD)
Entity Type:Individual
Prefix:DR
First Name:IGOR
Middle Name:
Last Name:TRILISKY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4061 POWDER MILL ROAD, SUITE 200
Mailing Address - Street 2:MEDSTAR MEDICAL GROUP RADIOLOGY LLC
Mailing Address - City:CALVERTON
Mailing Address - State:MD
Mailing Address - Zip Code:20705
Mailing Address - Country:US
Mailing Address - Phone:301-902-1063
Mailing Address - Fax:301-902-1086
Practice Address - Street 1:4061 POWDER MILL ROAD, SUITE 200
Practice Address - Street 2:MEDSTAR MEDICAL GROUP RADIOLOGY LLC
Practice Address - City:CALVERTON
Practice Address - State:MD
Practice Address - Zip Code:20705
Practice Address - Country:US
Practice Address - Phone:301-902-1063
Practice Address - Fax:301-902-1086
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2016-08-05
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Provider Licenses
StateLicense IDTaxonomies
IL125.0582222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology