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General NPI Number Information
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NPI Number | 1417052366
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Entity Type | Organization
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Legal Business Name | ANTON A. MINASSIAN PAIN MEDICINE & REHABILITATION SVCS
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 7984 OLD GEORGETOWN RD SUITE 7C
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City | BETHESDA
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State | MD
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Zip | 20814-2448
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Country | US
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Telephone | 301-654-4948
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Fax | 301-654-0770
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Provider Business Mailing Address
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Address Line | 7984 OLD GEORGETOWN RD SUITE 7C
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City | BETHESDA
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State | MD
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Zip | 20814-2448
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Country | US
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Telephone | 301-654-4948
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Fax | 301-654-0770
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ANTON ANTRANIK MINASSIAN
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Credential | M.D.
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Telephone | 301-654-4948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | D0051046
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | D0051046
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License Number State | MD
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