Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 4301080410 | MI |
Y | 2081P2900X | Pain Medicine | MD430910 | PA |
NPI | 1134276736 |
---|---|
Provider Name | Dr. Aleksandr Vladimirovich Mikhaylovskiy |
First Address | Jefferson Hills, PA 15025-3730 |
Second Address | Jefferson Hills, PA 15025-3730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 13/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1019157610001 | (05) | PA |
1398027 | BS (01) | |
1941855 | BSPA (01) | PA |
I71624 | (02) | PA |