Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | DR.0064075 | CO |
NPI | 1114260320 |
---|---|
Provider Name | Vadim Tsvankin |
First Address | Englewood, CO 80113-3916 |
Second Address | Englewood, CO 80113-3916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2013 |
Last Update Date | 10/02/2021 |