SERGEY SHKUROVICH (NPI# 1902070519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902070519 |
| Entity Type | Individual |
| Full Name | SERGEY SHKUROVICH |
| Credential | M.D. |
| Practice Address |
239 Greene St Mill Valley CA 94941-3516 |
| Mailing Address |
11995 Singletree Ln Suite 500 Eden Prairie MN 55344-5347 |
| Practice Telephone | 9525951301 |
| Practice Fax Number | 6122944903 |
| Mailing Telephone | 9525951301 |
| Mailing Fax Number | 6122944903 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2015-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
A104502 | CA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
245863 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
239 GREENE ST |
| City | MILL VALLEY |
| State | CA |
| Zip Code | 94941-3516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730707464 | Onward Cares, Inc. | Private Vehicle | 201 Morning Sun Ave, Mill Valley, CA 94941 | 2020-07-09 |
| 1255973848 | Cara Nicole Christie | Dietitian, Registered | 35 Miller Avenue Suite #273, Mill Valley, CA 94941 | 2019-10-15 |
| 1538698774 | Shari Lyn Coskey | Psychologist | 311 Miller Ave Ste A-1, Mill Valley, CA 94941 | 2017-06-10 |
| 1225572662 | Katelynn Allen | Physical Therapist | 421 Miller Ave, Mill Valley, CA 94941 | 2016-12-05 |
| 1134591340 | Sheree Lyn Reed | Pharmacist | 800 Redwood Hwy, Frontage Rd #10, Mill Valley, CA 94941 | 2015-10-27 |
| 1235527904 | Sheila Francis Lynch | Social Worker | 33 Millwood Street, Suite #3, Mill Valley, CA 94941 | 2015-01-05 |
| 1790197580 | Linden Farrar Berry | Marriage & Family Therapist | 275 Miller Avenue, Mill Valley, CA 94941 | 2014-05-28 |
| 1073930343 | Eman Elmi | Podiatrist | 7 North Knoll Road Suite 3, Mill Valley, CA 94941 | 2014-03-25 |
| 1053657726 | Susan Pauly-o'neill | Nurse Practitioner | 750 Redwood Hwy Frontage Rd, Mill Valley, CA 94941 | 2012-12-27 |
| 1598049652 | John Deri | Psychiatry & Neurology | 10 Millwood Street, Suite #4, Mill Valley, CA 94941 | 2011-10-06 |
| Find all providers in zip 94941 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851694699 | Riverside Radiology Medical Group, Inc. | Radiology | 338 Lowell Ave, Mill Valley, CA 94941-3845 | 2010-12-17 |
| 1932256468 | Michael John Gothelf | Radiology | 115 Country Club Drive, Mill Valley, CA 94941 | 2007-01-05 |
| 1134525181 | Online Radiology Medical Group, Inc. | Radiology | 338 Lowell Ave, Mill Valley, CA 94941-3845 | 2014-11-18 |
| 1164724498 | Remote Diagnostic Interpreters PC | Radiology | 338 Lowell Ave, Mill Valley, CA 94941-3845 | 2010-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902116 | Vesta Telemedicine Solutions, Pllc | Radiology | 833 Americana Way Unit 251, Glendale, CA 91210-1538 | 2020-11-04 |
| 1558960161 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 38209 47th St E Ste D, Palmdale, CA 93552-3113 | 2020-10-23 |
| 1003415613 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 38925 Trade Center Dr Unit E, Palmdale, CA 93551-3655 | 2020-10-23 |
| 1083213151 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 44105 15th St W Ste 100, Lancaster, CA 93534-4090 | 2020-10-20 |
| 1750980967 | Centrelake Medical Group Inc | Radiology | 430 W Stetson Ave, Hemet, CA 92543-7328 | 2020-10-19 |
| 1538775994 | Richard J. Moran | Radiology | 230 S Main St Ste 101, Orange, CA 92868-3851 | 2020-09-21 |
| 1417567710 | Family Medical Diagnostics Inc | Radiology | 19231 Victory Blvd Ste 356, Reseda, CA 91335-6308 | 2020-08-03 |
| 1396365011 | Prodiagnose Inc | Radiology | 7345 Topanga Canyon Blvd # 210, Canoga Park, CA 91303-1244 | 2020-04-22 |
| 1548892276 | Alvarado Radiology Group Inc, A Professional Corporation | Radiology | 13700 Marina Pointe Dr Unit 430, Marina Del Rey, CA 90292-9277 | 2020-02-11 |
| 1710518535 | Health Diagnostics of California A Professional Corporation | Radiology | 1690 Barton Rd Ste 107, Redlands, CA 92373-4230 | 2020-01-30 |
| Find all providers with the same taxonomy | ||||
| City | MILL VALLEY |
| Zip Code | 94941 |
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| 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.