Individual ProviderTatiana OussovaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address11929 Glen Mill Rd, Potomac, MD 20854-1920(301) 437-4873PECOS EnrollmentBased on the most recent information from CMS, provider Tatiana Oussova does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1053868091Provider TypeIndividualFull NameOussova, TatianaTitleDr.CredentialM.D.GenderFemaleSole ProprietorYesEnumeration Date9/7/2016Last Updated9/7/2016Contact InformationPractice LocationPractice Address11929 Glen Mill Rd, Potomac, MD 20854-1920Phone(301) 437-4873FaxUnlisted FaxMailing LocationMailing Address11929 Glen Mill Rd, Potomac, MD 20854-1920Phone(301) 437-4873FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseD0054626MarylandCode2083P0901XDescriptionPreventive MedicineAllopathic & Osteopathic PhysiciansLicenseD0054626Maryland