Masserman, Ivy Sue
Masserman, Ivy Sue is an individual health care provider with primary practice located at 2401 Blueridge Ave , Wheaton MD 20902-4517. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Masserman, Ivy Sue can be contacted via phone (301) 933-6440.Contact Information
Primary practice address
2401 Blueridge Ave
Wheaton MD 20902-4517
Phone: (301) 933-6440
Fax: (301) 933-5923
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | D39455 | Maryland |
Profile Details
| NPI number | 1821102450 |
|---|---|
| LBN Legal business name | Masserman, Ivy Sue |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821102450 | NPPES |
| Maryland | MEDICAID | 561161200 |
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