Individual
ELAHE MERYL SHYCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD # B100296, GAINESVILLE, FL 32610-3003
(352) 273-9001
Mailing address
4742 SW 57TH DR, GAINESVILLE, FL 32608-3862
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME131430
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021450800
—
FL
Enumeration date
05/27/2014
Last updated
08/30/2017
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