Healthcare Provider Details

I. General information

NPI: 1992333793
Provider Name (Legal Business Name): DAVID RISOV DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2020
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 WAYNE AVE STE 410
SILVER SPRING MD
20910-5655
US

IV. Provider business mailing address

1010 WAYNE AVE STE 410
SILVER SPRING MD
20910-5655
US

V. Phone/Fax

Practice location:
  • Phone: 240-600-0177
  • Fax:
Mailing address:
  • Phone: 240-600-0177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberH0099050
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberH0099050
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: