Organization
MSN CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VYACHESLAV DUBROVSKY APNP BC (PRESIDENT)
(414) 915-6255
Entity
Organization
Contact information
Practice address
9330 W LINCOLN AVE STE 10, WEST ALLIS, WI 53227-2300
(414) 366-2985
Mailing address
12507 N EMILY LN, MEQUON, WI 53092-2611
(414) 915-6255
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669032363
NPI
—
Enumeration date
06/17/2019
Last updated
08/14/2019
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