Individual
BORIS VINOGRADSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36100 EUCLID AVE STE 330B, WILLOUGHBY, OH 44094-4489
(440) 953-8055
(440) 953-0242
Mailing address
36100 EUCLID AVE STE 330B, WILLOUGHBY, OH 44094-4489
(440) 953-8055
(440) 953-0242
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35.075888
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000227664
BLUECROSS BLUESHIELD
OH
05
—
2224499
—
OH
01
—
P00275951
RR MEDICARE
OH
Enumeration date
01/25/2006
Last updated
10/09/2015
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