Individual
SERHIY MASLOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2808 OUTER DR, MARION, IL 62959-5207
(618) 993-3817
(618) 993-3908
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.007952
IL
363A00000X
Physician Assistant
Primary
085007952
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/01/2020
Last updated
10/05/2022
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