Individual
DENIS YUSUPOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(757) 388-8870
Mailing address
450 CLARKSON AVE DEPT OF, BROOKLYN, NY 11203-2012
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101282246
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/25/2017
Last updated
07/26/2024
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