Individual
DMITRY M VLASOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
(414) 328-7950
Mailing address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
(414) 328-7950
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
50189-20
WI
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
46891
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
721151100
—
MN
Enumeration date
01/03/2006
Last updated
12/30/2021
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