Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 2020034383 | MO |
N | 207L00000X | Anesthesiologist | ME113181 | FL |
NPI | 1003912213 |
---|---|
Provider Name | Dr. Oleksiy Mykhaylovych Zyernov |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65212-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 08/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003124548A | (05) | GA |
005790500 | (05) | FL |
14K87 | BCBSFL (01) | FL |