| Doctor Name: | TATJANA MISUNINA |
| NPI Number: | 1053717660 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | C05529 |
| Business Practice Address: | 21 Woodenbridge Ct Reisterstown, MD - 211363727 |
| Business Phone Number: | 4102455367 |
| Business Fax Number: | |
| Mailing Address: | 21 Woodenbridge Ct, REISTERSTOWN |
| State: | MD |
| Postal Code: | 211363727 |
| Phone Number: | 4102455367 |
| Fax Number: | |
| NPI Enumeration Date: | 11/10/2014 |
| NPI Last Update Date: | 11/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | C05529 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |