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Contact Information

MARIO K DIMITROV, PA-C
5401 OLD COURT ROAD
NORTHWEST HOSPITAL CENTER
RANDALLSTOWN, MD21133
 Phone: 410-521-2200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MARIO K DIMITROV · (Male)

NPI Number 1013939255
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/24/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MD License # C0002204
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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