Healthcare Provider Details
I. General information
NPI: 1639693435
Provider Name (Legal Business Name): MD FIRST ASSISTANT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/02/2017
Last Update Date: 01/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8156 S WADSWORTH BLVD UNIT E-337
LITTLETON CO
80128-9114
US
IV. Provider business mailing address
8156 S WADSWORTH BLVD UNIT E-337
LITTLETON CO
80128-9114
US
V. Phone/Fax
- Phone: 281-462-4854
- Fax:
- Phone: 281-462-4854
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246ZC0007X |
| Taxonomy | Surgical Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MIKHAIL
DRUZHININ
Title or Position: OWNER
Credential: CSFA
Phone: 720-442-2988