Individual
MYKOLA TSAPENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 MORRIS ST, SUITE 357, CHARLESTON, WV 25301-1326
(304) 388-3574
(304) 388-6481
Mailing address
415 MORRIS ST, SUITE 304, CHARLESTON, WV 25301-1842
(304) 388-7782
(304) 388-7788
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
49069
MN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
26423
WV
207RN0300X
Nephrology Physician
49069
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806400000
—
MN
01
—
P00632043
MEDICARE, RAILROAD
MN
Enumeration date
09/14/2006
Last updated
05/20/2012
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