Medvedev, Ivan

Medvedev, Ivan is an individual health care provider with primary practice located at 1959 Ne Pacific St Box 356422, Seattle WA 98195-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Medvedev, Ivan can be contacted via phone (857) 919-6367.

Contact Information

Primary practice address
1959 Ne Pacific St Box 356422 Seattle WA 98195-0001
Phone: (857) 919-6367
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD60222650 Washington
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD60222650 Washington

Profile Details

NPI number 1629236187
LBN Legal business name Medvedev, Ivan
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2008
Last updated Jun 17th, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629236187 NPPES
Washington MEDICAID 1629236187

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