Individual
NINO DGEBUADZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
17 WESTERN MARYLAND PKWY, SUITE 100, HAGERSTOWN, MD 21740
(301) 797-9240
(301) 797-4119
Mailing address
4444 FOREST PARK AVE, CAMPUS BOX 8518, SAINT LOUIS, MO 63108-8518
(314) 454-7757
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2007012244
MO
208100000X
Physical Medicine & Rehabilitation Physician
Primary
D0073349
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
333505400
—
MD
01
—
97628601
BCBS LOCAL CAREFIRST KG85
MD
01
—
P01024230
RR MEDICARE MD
MD
01
—
W2660030
BCBS REGIONAL W266
MD
Enumeration date
06/27/2007
Last updated
11/20/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us