Physician Compare National (NPI:1598927824)

HEALTHCARE PROVIDER: NICKOLAY PETER MARKOV MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1598927824
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8123377090
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200108002656
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MARKOV
	Individual professional last name
Provider First Name	NICKOLAY
	Individual professional first name
Provider Middle Name	PETER
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GENERAL SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GENERAL SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	ALLIANCE PHYSICIANS INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0840104360
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	754
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3535 SOUTHERN BLVD
	Group Practice or individual's line 1 address
City	KETTERING
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	454291221
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9377522305
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	150017
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LUTHERAN HOSPITAL OF INDIANA
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y