DR. ANDREI R SHUSTOV


Address: 825 Eastlake Avenue E, G3-200, Seattle, WA 98109-1023
Phone: 2062886739

DR. ANDREI R SHUSTOV (NPI# 1346247632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346247632
Entity Type Individual
Full Name DR. ANDREI R SHUSTOV
Credential MD
Practice Address 825 Eastlake Avenue E
G3-200
Seattle
WA 98109-1023
Practice Telephone 2062886739
Practice Fax Number 2062886473
Mailing Telephone 2062886739
Mailing Fax Number 2062886473
Enumeration Date 2005-07-01
Last Update Date 2008-05-29
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RH0003X Internal Medicine
Specialization: Hematology & Oncology
MD00042672 WA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WA 8421596 05

Office Location

Street Address 825 EASTLAKE AVENUE E
G3-200
City SEATTLE
State WA
Zip Code 98109-1023

Providers in the same location

NPI Name Taxonomy Address Enumeration
1598292476 Lindsay Mk Aronson Physician Assistant 825 Eastlake Avenue E, Seattle, WA 98109-1023 2017-05-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1710590179 Direct Urgent Care Inc Internal Medicine 220 6th Avenue North, Seattle, WA 98109 2020-08-26
1073147104 Hannah Christine Hoyt Registered Nurse 1354 Aloha St, Seattle, WA 98109 2020-02-27
1508402645 Emily Elizabeth Rock Counselor Rain City Integrative Clinic, 2730 Westlake Ave N, Seattle, WA 98109 2019-11-25
1770048464 Roger Leach Massage Therapist 4162, Roy Street, Seattle, WA 98109 2019-02-06
1306316658 Laura Katie Richer Counselor 1817 Queen Anne Ave. N., 204, Seattle, WA 98109 2018-11-29
1912492828 One Medical Group of Washington, P.C. Psychologist 625 Boren Avenue North, Seattle, WA 98109 2018-06-25
1942793526 Washington Dental Corporation, PC Dentist 527 Boren Ave N, Seattle, WA 98109 2018-06-08
1417449968 Chelsie Mccalla Occupational Therapy Assistant Mirabella, 116 Fairview Ave N, Seattle, Seattle, WA 98109 2018-05-31
1710405964 Next Level Sports Performance Consulting Clinic/Center 24 Roy Street, #461, Seattle, WA 98109 2017-09-07
1679091953 Amy Ly Indorf Pharmacist 825 Eastlake Ave E #msg5-90, Seattle, WA 98109 2017-09-06
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Taxonomy Information

Taxonomy Code 207RH0003X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hematology & Oncology

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477150969 John Michael Pesando Internal Medicine 1066 East Blaine Street, Seattle, WA 98102-4260 2020-10-07
1265944003 Langdon Leforrest Miller Internal Medicine 3057 Perkins Ln W, Seattle, WA 98199-2418 2017-11-02
1306214168 Alvaro Perona Blazquez Internal Medicine 5049 38th Ave Ne, Seattle, WA 98105-3022 2015-09-10
1013318245 Vivien R V B Santos Internal Medicine 5049 38th Avenue Ne, Seattle, WA 98105 2014-09-08
1154663581 Victor Alexander Chow Internal Medicine 1100 Fairview Ave N # D5-390, Seattle, WA 98109-4433 2013-03-24
1508150111 Robert Eugene Burdick Internal Medicine 2201 39th Ave E, Seattle, WA 98112-2401 2011-06-01
1124334792 Wayne Russell Godfrey Internal Medicine 410 W Harrison St, Suite 100, Seattle, WA 98119-4033 2010-08-20
1407173826 Joshua Robert Veatch Internal Medicine 1100 Fairview Ave N # D5-100, Seattle, WA 98109-4433 2010-04-24
1346562816 Song Zhao Internal Medicine 515 Minor Ave Fl 1, Seattle, WA 98104-2120 2010-02-24
1497925051 Stephen Douglas Smith Internal Medicine 825 Eastlake Ave E # G3-200, Seattle, WA 98109-4405 2008-03-10
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Competitor

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City SEATTLE
Zip Code 98109

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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