Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 5101017730 | MI |
NPI | 1023270477 |
---|---|
Provider Name | Dr. Andrey Alex Volkov |
First Address | Detroit, MI 48236-2169 |
Second Address | Detroit, MI 48236-2169 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 27/07/2015 |