Basic Information
Provider Information
NPI: 1396988283
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZEMSKOVA
FirstName: MARINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: RYBAKOVA
OtherFirstName: MARINA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 15825 SHADY GROVE RD
Address2: SUITE 140
City: ROCKVILLE
State: MD
PostalCode: 208504008
CountryCode: US
TelephoneNumber: 3018699776
FaxNumber: 3012162592
Practice Location
Address1: 15825 SHADY GROVE RD
Address2: SUITE 140
City: ROCKVILLE
State: MD
PostalCode: 208504008
CountryCode: US
TelephoneNumber: 3018699776
FaxNumber: 3012162592
Other Information
ProviderEnumerationDate: 04/08/2009
LastUpdateDate: 04/08/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101XD0061286MDY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

No ID Information.


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