Dr. Michael Mstislavovich Ivanitsky
Orthopaedic Surgeon
940 E 5th St
Coquille
, Oregon 97423-1699
Dr. Michael Mstislavovich Ivanitsky
Orthopaedic Surgeon
940 E 5th St
Coquille
, Oregon 97423-1699
(541) 396-8135
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About
Features
Specialties
- Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Michael Mstislavovich Ivanitsky
- 940 E 5th St
- Coquille, OR
- Zip : 97423-1666
- Fax : (541) 396-8135
- Phone : (541) 396-3111
Second Address
- Dr. Michael Mstislavovich Ivanitsky
- 940 E 5th St
- Coquille, OR
- Zip : 97423-1699
- Fax : (541) 396-8135
- Phone : (541) 396-3111
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgeon | MD22589 | OR |
National Provider Identifier
| NPI | 1003837410 |
|---|---|
| Provider Name | Dr. Michael Mstislavovich Ivanitsky |
| First Address | Coquille, OR 97423-1666 |
| Second Address | Coquille, OR 97423-1699 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/07/2006 |
| Last Update Date | 04/09/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 288121 | (05) | OR |
| F84579 | (02) | OR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.