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Individual

DR. DMITRY E. KIYATKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0100
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D65844
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
013542900
MD
Enumeration date
12/06/2006
Last updated
06/06/2023
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