Individual
MICHAEL JON PISHVAIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5255 LOUGHBORO RD NW BLDG B, WASHINGTON, DC 20016-2633
(202) 660-6500
(202) 660-6501
Mailing address
5255 LOUGHBORO RD NW, WASHINGTON, DC 20016-2633
(410) 955-5000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD035033
DC
207RX0202X
Medical Oncology Physician
Primary
D71401
MD
207RX0202X
Medical Oncology Physician
S0972
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
397339801
—
TX
01
—
397339802
CSHCN MEDICAID
TX
Enumeration date
08/30/2007
Last updated
08/23/2021
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