Provider Demographics
NPI:1194380428
Name:TSOLAKIAN, IBRAHIM (MD)
Entity type:Individual
Prefix:DR
First Name:IBRAHIM
Middle Name:
Last Name:TSOLAKIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 UPPER CHESAPEAKE DR SUITE 301
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014
Mailing Address - Country:US
Mailing Address - Phone:443-643-4300
Mailing Address - Fax:443-643-4303
Practice Address - Street 1:520 UPPER CHESAPEAKE DR SUITE 301
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014
Practice Address - Country:US
Practice Address - Phone:443-643-4300
Practice Address - Fax:443-643-4303
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD0096288207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program