Individual
VADIM KHACHATUROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUSTAVE L LEVY PL, 15TH FLOOR, NEW YORK, NY 10029-6500
(212) 241-8014
(212) 426-5129
Mailing address
2646 MAYFIELD RD, APT. 304, CLEVELAND, OH 44106-5509
(917) 656-3056
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301110433
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2011
Last updated
07/31/2023
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