; NPI #1881206522

Contact Information

IVAN KUZNETSOV

34585 US HIGHWAY 59 SE
ERSKINE, MN 56535-9465

Phone: 218-902-0653
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Private Vehicle	347C00000X

Indicates primary specialty

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NPI Profile & details for

NPI Number 1881206522

Entity Organization

Organization subpart ¹ Not specified

Enumeration date 08/22/2020

Last updated 08/22/2020 - About 6 years ago

Identifiers

License #

383545

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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Specialty

Private Vehicle

NPI Profile & details for

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