Individual
DR. VADIM EDWARD KORKHOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 HOSPITAL DR, GLEN BURNIE, MD 21061-5803
(410) 787-4000
Mailing address
1411 GRANDVIEW AVE, #103, PITTSBURGH, PA 15211-1165
(917) 476-2065
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
231475
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
D0068240
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000554504
ANTHEM
IN
05
—
200890270
—
IN
Enumeration date
06/08/2006
Last updated
10/06/2008
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