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Individual

OLEG PISMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
2001 152ND AVE NE, REDMOND, WA 98052-5521
(425) 643-8901
(425) 643-8902
Mailing address
2001 152ND AVE NE, REDMOND, WA 98052-5521
(206) 830-0920

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
N006201
NY
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO 00000822
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000121894
GHI HMO
NY
01
000413920001
BLUE SHIELD
NY
01
0174899
GHI PPO
NY
05
02926130
NY
01
10128382
CDPHP
NY
01
2850709
UNITEDHEALTHCARE
NY
01
4159492
MVP
NY
01
9692074
AETNA
NY
01
P00427572
RAILROAD MEDICARE
Enumeration date
03/09/2007
Last updated
04/05/2016
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