Individual
MYKOLA KOLGANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2351 E 22ND ST STE 338W, CLEVELAND, OH 44115-3111
(216) 861-6200
(216) 363-7490
Mailing address
PO BOX 5023, CLEVELAND, OH 44101-0023
(626) 200-8714
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
35.139019
OH
207R00000X
Internal Medicine Physician
57.029851
OH
Other
Enumeration date
06/22/2017
Last updated
10/27/2021
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