Organization
SELEVERSTOV MEDICAL, P.C.
Active
Organization
SELEVERSTOV MEDICAL, P.C.
Active
Other names
Heritage Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
OLEKSANDR SELEVERSTOV MD (OWNER)
(518) 801-6446
Entity
Organization
Contact information
Practice address
56 N COLLEGE AVE UNIT 2A, COLLEGE PLACE, WA 99324-1048
(097) 300-7285
(866) 531-7606
Mailing address
146 THUNDER RIDGE DR, WALLA WALLA, WA 99362-7762
(518) 801-6446
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
01/29/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up