Individual
OLEG V SERBINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1510 E WAGON WHEEL LN, STE. 110, FORT MOHAVE, AZ 86426-6697
(928) 788-3333
(928) 788-3555
Mailing address
PO BOX 10966, FORT MOHAVE, AZ 86427-0966
(928) 788-3333
(928) 788-3555
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
37626
AZ
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
37626
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103360
—
AZ
Enumeration date
07/29/2006
Last updated
09/01/2016
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