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Individual

DR. VLADIMIR KATYSHEV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
250 E DUNLAP AVE, PHOENIX, AZ 85020-2825
(313) 745-4275
Mailing address
111 E DUNLAP AVE STE 1-279, PHOENIX, AZ 85020-7805
(313) 745-4275

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
53271
AZ
2084A2900X
Neurocritical Care Physician
Primary
53271
AZ
2084N0400X
Neurology Physician
4301098616
MI
2084N0400X
Neurology Physician
53271
AZ
2084V0102X
Vascular Neurology Physician
53271
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
53271
ARIZONA MEDICAL BOARD
AZ
Enumeration date
08/03/2011
Last updated
03/11/2021
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