Individual
DR. NIKOLAY MINDADZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C1-0008143
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102891261 001
—
PA
01
—
144677500
DEPARTMENT OF LABOR
DE
05
—
1447305107
—
DE
05
—
266108000
—
MD
Enumeration date
01/24/2007
Last updated
12/05/2017
Update your record
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