Individual
DR. NIKOLAY MINDADZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4735 OGLETOWN STANTON ROAD, SUITE 3301, MEDICAL ARTS PAVILLION 2, NEWARK, DE 19713-2067
(302) 623-4370
(302) 623-4375
Mailing address
200 HYGEIA DR STE 2300, NEWARK, DE 19713-2049
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
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