Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35.084047 | OH |
Y | 208600000X | Surgeon | 35.084047 | OH |
N | 2086S0122X | Plastic and Reconstructive Surgery | M2660 | TX |
NPI | 1023081221 |
---|---|
Provider Name | Dr. Raymond Isakov |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 15/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
612358 | PROVIDER NO. CMS (01) | TX |
I51793 | (02) | TX |