Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | C10012721 | DE |
Y | 213ES0000X | Sports Medicine | C10012721 | DE |
NPI | 1386054484 |
---|---|
Provider Name | Dr. Kirill Alekseyev |
First Address | Dover, DE 19904-1381 |
Second Address | Dover, DE 19904-1381 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2014 |
Last Update Date | 14/01/2019 |