Individual
STANISLAV M POLIASHENKO
Active
Individual
STANISLAV M POLIASHENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
6240
GA
2085R0202X
Diagnostic Radiology Physician
Primary
61493
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111257135
MEDICARE
KS
01
—
832216
MEDICARE
CO
01
—
832218
MEDICARE
CO
01
—
832219
MEDICARE
CO
05
—
9000170766
—
CO
01
—
KA3249126
MEDICARE
KS
01
—
NA1214147
MEDICARE
NE
01
—
NA1215148
MEDICARE
NE
01
—
NA2517124
MEDICARE
NE
Enumeration date
04/22/2013
Last updated
03/31/2024
Update your record
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