Shustov, Andrei R

Shustov, Andrei R is an individual health care provider with primary practice located at 825 Eastlake Avenue E G3-200, Seattle WA 98109-1023. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Shustov, Andrei R can be contacted via phone (206) 288-6739.

Contact Information

Primary practice address
825 Eastlake Avenue E G3-200 Seattle WA 98109-1023
Fax: (206) 288-6473
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X MD00042672 Washington

Profile Details

NPI number 1346247632
LBN Legal business name Shustov, Andrei R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated May 29th, 2008 - about 16 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 1346247632 NPPES
Washington MEDICAID 8421596

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