Individual
VLADIMIR MEDVED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
24 4TH ST, MALONE, NY 12953-1350
(518) 481-6044
(518) 481-6043
Mailing address
24 4TH ST, MALONE, NY 12953-1350
(518) 481-6044
(518) 481-6043
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
221956
NY
208VP0000X
Pain Medicine Physician
Primary
221956
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02410126
—
NY
01
—
364145
MVP HEALTH PLAN
NY
01
—
5996910
GHI FAMILY HEALTH PLUS
NY
01
—
P00189181
RAILROAD MEDICARE
NY
01
—
P010221956
BLUE CROSS/BLUE SHIELD
NY
Enumeration date
10/16/2006
Last updated
02/22/2016
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