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Individual

DR. ANDREI R SHUSTOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
825 EASTLAKE AVENUE E, G3-200, SEATTLE, WA 98109-1023
(206) 288-6739
(206) 288-6473
Mailing address
825 EASTLAKE AVENUE E, G3-200, SEATTLE, WA 98109-1023
(206) 288-6739
(206) 288-6473

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD00042672
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8421596
WA
Enumeration date
07/01/2005
Last updated
05/29/2008
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