Individual
MAKSIM BOGUSLAVSKIY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
500 PLAZA CT, EAST STROUDSBURG, PA 18301-8262
(570) 426-2301
Mailing address
2100 MACK BLVD FL 4, ALLENTOWN, PA 18103-5622
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
73584
MN
2086S0102X
Surgical Critical Care Physician
Primary
OS023953
PA
Other
Enumeration date
03/28/2017
Last updated
09/09/2024
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