Individual
LILIT VARDANYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1110 ANNAPOLIS RD, ODENTON, MD 21113-1602
(443) 351-3917
Mailing address
PO BOX 759047, BALTIMORE, MD 21275-9047
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0005152
MD
Other
Enumeration date
10/03/2013
Last updated
03/26/2018
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