Individual
IVAN TSUTSKIRIDZE
Active
Individual
IVAN TSUTSKIRIDZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
9781
ND
207R00000X
Internal Medicine Physician
Primary
MD444322
PA
208M00000X
Hospitalist Physician
MD444322
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026484200001
—
PA
05
—
13141
—
ND
01
—
24668
NORTH DAKOTA BLUE SHIELD
ND
01
—
2669208
HIGHMARK BLUE SHIELD
PA
01
—
3865276000
KEYSTONE IBC
PA
Enumeration date
07/16/2006
Last updated
04/13/2022
Update your record
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