Individual
TATYANA SHVILKINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
(508) 765-3195
Mailing address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
(617) 869-3252
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
286838
MA
207P00000X
Emergency Medicine Physician
303904
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2016
Last updated
06/28/2021
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