Golub, Vitaly
Golub, Vitaly is an individual health care provider with primary practice located at 1500 S Main St , Fort Worth TX 76104-4917. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Golub, Vitaly can be contacted via phone (817) 702-3431.Contact Information
Primary practice address
1500 S Main St
Fort Worth TX 76104-4917
Phone: (817) 702-3431
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | P6399 | Texas |
Profile Details
| NPI number | 1346404993 |
|---|---|
| LBN Legal business name | Golub, Vitaly |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2008 |
| Last updated | Jun 11th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346404993 | NPPES |
| New York | MEDICAID | 03295778 |
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