Healthcare Provider Details

I. General information

NPI: 1033214853
Provider Name (Legal Business Name): SLAVKA ASSENOVA VASSILIEVA MINASSIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 08/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7984 OLD GEORGETOWN RD SUITE 7C
BETHESDA MD
20814-2448
US

IV. Provider business mailing address

7984 OLD GEORGETOWN RD SUITE 7C
BETHESDA MD
20814-2448
US

V. Phone/Fax

Practice location:
  • Phone: 301-654-4948
  • Fax: 301-654-0770
Mailing address:
  • Phone: 301-654-4948
  • Fax: 301-654-0770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberD0059620
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: