Individual
ALEKSANDR FEDOVSKIY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAAA
Contact information
Practice address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5085
(678) 604-1053
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(954) 839-2569
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
003692
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000335A
—
GA
Enumeration date
11/30/2005
Last updated
03/29/2023
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