Provider Demographics
NPI:1316945652
Name:PASMANIK, ELVIRA (MD)
Entity type:Individual
Prefix:DR
First Name:ELVIRA
Middle Name:
Last Name:PASMANIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 LIBERTY RD FL 2
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4767
Mailing Address - Country:US
Mailing Address - Phone:410-521-4211
Mailing Address - Fax:410-521-0627
Practice Address - Street 1:8600 LIBERTY RD FL 2
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4767
Practice Address - Country:US
Practice Address - Phone:410-521-4211
Practice Address - Fax:410-521-0627
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2021-01-15
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-21
Provider Licenses
StateLicense IDTaxonomies
MDD0059228207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403364700Medicaid
MDH87110Medicare UPIN
MD403364700Medicaid