Provider Demographics
NPI:1154404754
Name:KRUPNIKOVA, NADIA (MD)
Entity type:Individual
Prefix:DR
First Name:NADIA
Middle Name:
Last Name:KRUPNIKOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NADIA
Other - Middle Name:
Other - Last Name:WOLKOW-KRUPNIKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 CHURCH STREET
Mailing Address - Street 2:SUITE 602
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:240-314-0691
Mailing Address - Fax:240-314-0696
Practice Address - Street 1:1 CHURCH ST
Practice Address - Street 2:SUITE 602
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:240-314-0691
Practice Address - Fax:240-314-0696
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00518232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F26791Medicare UPIN
721775Medicare ID - Type Unspecified