Individual
VITALY KISHINYOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2145 MOUNT PLEASANT BLVD SE, ROANOKE, VA 24014-3632
(540) 427-9200
Mailing address
2145 MOUNT PLEASANT BLVD SE, ROANOKE, VA 24014-3632
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
116020178
VA
Other
Enumeration date
06/10/2008
Last updated
06/10/2008
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