MEDICARE: NIKOLAY Z. TCHOPEV M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	D0065507	MD
2	208000000X	Pediatrics Physician	D0065507	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023010394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKOLAY Z. TCHOPEV M.D.

Provider Business Mailing Address
First Line	:	5328 DUNTEACHIN DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-8204
Country	:	US
Telephone Number	:	410-350-1090
Fax Number	:	855-543-4914

Provider Business Practice Location Address
First Line	:	5328 DUNTEACHIN DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-8204
Country	:	US
Telephone Number	:	410-350-1090
Fax Number	:	855-543-4914

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	03/01/2014

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