Individual
MR. ALEKSANDR V POTASHNIK
Active
Individual
MR. ALEKSANDR V POTASHNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9101320
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290891300
—
FL
01
—
E4612Z
MEDICARE ID- TYPE UNSPECI
FL
01
—
P00684926
RAILROAD MEDICARE
FL
Enumeration date
09/06/2005
Last updated
06/26/2013
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