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Individual

ALEKSANDR GOLDVEKHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7235 W APPLETON AVE, MILWAUKEE, WI 53216-1932
(414) 815-6700
(414) 755-1434
Mailing address
711 DUNHILL DR, BUFFALO GROVE, IL 60089-1514
(847) 530-9317

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
P6398
TX
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
8211
TX
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
01064540A
IN
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
36110569
IL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
P6398
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000557721
BLUE CROSS / BLUE SHIELD
IN
01
000000564577
BLUE CROSS / BLUE SHIELD
IN
01
01064540A
STATE LICENSE
IN
01
36110569
STATE LICENSE
IL
01
57560
WISCONSIN LICENSE
WI
01
K400108110
MC FOR MRT
WI
Enumeration date
07/22/2006
Last updated
06/20/2014
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