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1013939255
MARIO KLIMENTOV DIMITROV
RANDALLSTOWN, MD
NPI
1013939255
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: MD C0002204)
Enumeration Date
2006-07-24
Last Update Date
2007-07-08
Business Address
Mr. MARIO KLIMENTOV DIMITROV PA-C
5401 OLD COURT ROAD NORTHWEST HOSPITAL CENTER
RANDALLSTOWN, MD 21133
Phone number: 410-521-2200
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Mailing Address
Mr. MARIO KLIMENTOV DIMITROV PA-C
5401 OLD COURT RD ATTN: CREDENTIALING
RANDALLSTOWN, MD 21133-5103
Phone number: 410-601-5524
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