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Individual

MARINA MEDVED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
24 4TH ST, NORTH COUNTRY HEALTHCARE, MALONE, NY 12953-1329
(518) 481-6044
Mailing address
24 4TH ST, NORTH COUNTRY HEALTHCARE, MALONE, NY 12953-1329
(518) 481-6044

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
219878
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02409772
NY
01
364144
MVP HEALTH PLAN
NY
01
5996909
GHI FAMILY HEALTH PLUS
NY
01
P010219878
EXCELLUS BCBS
NY
Enumeration date
06/11/2006
Last updated
05/06/2008
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