Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 38637 | IA |
N | 208000000X | Pediatrician | 38637 | IA |
N | 208000000X | Pediatrician | N2800 | TX |
NPI | 1841434537 |
---|---|
Provider Name | Oleg A Shchelochkov |
First Address | Iowa City, IA 52242-1007 |
Second Address | Iowa City, IA 52242-1007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2009 |
Last Update Date | 09/02/2010 |