Organization
PHYSICIAN HOUSE CALL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VYACHESLAV ISAKOV MD (MEDICAL DIRECTOR)
(216) 201-0339
Entity
Organization
Contact information
Practice address
402 SANDHURST DR, HIGHLAND HEIGHTS, OH 44143-3604
(216) 201-0339
Mailing address
402 SANDHURST DR, HIGHLAND HEIGHTS, OH 44143-3604
(216) 201-0339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1845089
OH
207QG0300X
Geriatric Medicine (Family Medicine) Physician
1845089
OH
208D00000X
General Practice Physician
Primary
1845089
OH
213E00000X
Podiatrist
1845089
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2939495
—
OH
Enumeration date
04/13/2009
Last updated
08/01/2011
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