Individual
IVAYLO GEORGIEV NINOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
12504 SWEET LEAF TER, FAIRFAX, VA 22033-2461
(571) 276-4518
Mailing address
12504 SWEET LEAF TER, FAIRFAX, VA 22033-2461
(571) 276-4518
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
0001293326
VA
Other
Enumeration date
01/30/2023
Last updated
01/30/2023
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