Individual provider · Type 1 NPI

Giorgi Maisuradze, MD

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1174457600 Active

Practice location

2601 Holme Avenue, Nazareth Hospital, Gme Office, 3rd Floor Marian Buildin
Philadelphia, PA 19152

Call (267) 350-7401 Map

Fax (267) 350-7441

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1174457600

Giorgi Maisuradze, MD's National Provider Identifier is 1174457600, issued on Jun 10, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Sep 9, 2026.