Individual
MR. SERGEY L ISTOMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP, PMHNP-BC
Contact information
Practice address
6040 SOUTHPORT DR, BETHESDA, MD 20814-1848
(301) 493-4200
Mailing address
6040 SOUTHPORT DR, BETHESDA, MD 20814-1848
(301) 493-4200
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R208690
MD
Other
Enumeration date
03/26/2012
Last updated
12/03/2013
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