Individual
MICHAEL OSTAPCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
917 W WALNUT ST, JOHNSON CITY, TN 37604
(423) 439-6464
(423) 439-7118
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 439-6464
(423) 439-7118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
27248
KY
207Q00000X
Family Medicine Physician
Primary
MD56839
TN
208000000X
Pediatrics Physician
27248
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200162470
—
IN
05
—
64272487
—
KY
Enumeration date
05/15/2006
Last updated
08/24/2018
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