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1194080374
IVAN BORISSOW
BALTIMORE, MD
NPI
1194080374
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MD C04854)
Enumeration Date
2012-07-12
Last Update Date
2020-05-11
Business Address
Mr. IVAN BORISSOW PA-C
5601 LOCH RAVEN BLVD
BALTIMORE, MD 21239-2945
Phone number: 443-444-8000
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Mailing Address
Mr. IVAN BORISSOW PA-C
5601 LOCH RAVEN BLVD
BALTIMORE, MD 21239-2945
Phone number: 443-444-8000
Copy
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