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General NPI Number Information
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NPI Number | 1932908696
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Entity Type | Individual
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Provider Name | VICTORIA PANJIKIDZE
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Gender | Female
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 15245 SHADY GROVE RD STE 150
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City | ROCKVILLE
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State | MD
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Zip | 20850-7210
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Country | US
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Telephone | 301-869-9776
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Fax |
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Provider Business Mailing Address
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Address Line | 4515 WILLARD AVE APT S1901
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City | CHEVY CHASE
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State | MD
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Zip | 20815-3672
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Country | US
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Telephone | 202-469-2368
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R254002
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License Number State | MD
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