Individual
KRISTINA KISSIOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15235 SHADY GROVE RD STE 105, ROCKVILLE, MD 20850-6278
(301) 990-3030
Mailing address
37 BELLOWS CT, TOWSON, MD 21204-2717
(410) 585-5658
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0093635
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2019
Last updated
07/30/2022
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