VIACHESLAV IREMASHVILI (NPI# 1407115876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407115876 |
| Entity Type | Individual |
| Full Name | VIACHESLAV IREMASHVILI |
| Credential | M.D. |
| Practice Address |
135 Professional Pl Bridgeport WV 26330-4509 |
| Practice Telephone | 6813423660 |
| Practice Fax Number | 6813423598 |
| Mailing Telephone | 6813423660 |
| Mailing Fax Number | 6813423598 |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2018-06-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 28077 | WV | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 67519 | WI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10350 Haligus Road, 200, Huntley, IL 60142 | 8153386600 |
| Street Address |
135 PROFESSIONAL PL |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-4509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902803331 | Michael M Dutkevicz | Physician Assistant | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2005-06-30 |
| 1700139045 | Salvatore Marino | Physician Assistant | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2012-10-24 |
| 1558636274 | Laura E Potesta | Physician Assistant | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2012-03-13 |
| 1023337193 | United Hospital Center, Inc | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2010-05-27 |
| 1851555460 | Oluyemi Akin-olugbade | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2008-07-12 |
| 1407881535 | Grant L Franklin Jr. | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2006-07-11 |
| 1467405217 | William Tuong | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2006-05-19 |
| 1821082272 | Scott K Luttge | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740667815 | Keith Richard O'brien | Urology | 2600 Main St Ste 119, Bridgeport, CT 06606-5305 | 2015-04-28 |
| 1235295577 | The Urology Center, Pllc | Urology | 9 Chenoweth Dr # B, Bridgeport, WV 26330-1675 | 2006-12-29 |
| 1750375549 | Jeffrey Daniel Small | Urology | 4695 Main St, Bridgeport, CT 06606-1802 | 2005-09-07 |
| 1023337193 | United Hospital Center, Inc | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2010-05-27 |
| 1851555460 | Oluyemi Akin-olugbade | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2008-07-12 |
| 1427168707 | Milton Armm Md PC | Urology | 3180 Main Street, Room 305, Bridgeport, CT 06606 | 2006-08-30 |
| 1679683965 | Milton Frank Armm | Urology | 3180 Main Street, Room 305, Bridgeport, CT 06606 | 2006-08-30 |
| 1407881535 | Grant L Franklin Jr. | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2006-07-11 |
| 1467405217 | William Tuong | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2006-05-19 |
| 1821082272 | Scott K Luttge | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2005-08-31 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
Please comment or provide details below to improve the information on VIACHESLAV IREMASHVILI.
| 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.