Igor V Legostaev (NPI# 1982634648, PAC ID# 6406859313) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1982634648 |
| PAC ID by PECOS | 6406859313 |
| Professional Enrollment ID | I20060815000245 |
| Full Name | Igor V Legostaev |
| Organization Legal Name | CANTRELL LAKE INPATIENT SERVICES LLC |
| Address |
200 Allen Memorial Dr Bremen GA 30110-2012 |
| Phone Number | 7708122000 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1988 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 1254604101 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 010012 | DEKALB REGIONAL MEDICAL CENTER |
| 111320 | HIGGINS GENERAL HOSPITAL |
| 110011 | TANNER MEDICAL CENTER - CARROLLTON |
| Address | Phone | Organization |
|---|---|---|
| 200 Allen Memorial Dr, Bremen, GA 30110-2012 | 7708122000 | CANTRELL LAKE INPATIENT SERVICES LLC |
| 200 Medical Ctr Dr Sw, Fort Payne, AL 35968-3458 | 2568453150 | PHYSYNERGY MEDICAL SERVICES LLC |
| 1 Hospital Dr Sw, Huntsville, AL 35801-6455 | 2568823100 | PHYSYNERGY MEDICAL SERVICES LLC |
| Organization Legal Name | CANTRELL LAKE INPATIENT SERVICES LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Janice K Bain | Internal Medicine | Cantrell Lake Inpatient Services LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Habigaile Cribe | Internal Medicine | Cantrell Lake Inpatient Services LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Muhammad A Pervaiz | Hospitalist | Cantrell Lake Inpatient Services LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Joel D Megli | Internal Medicine | Cantrell Lake Inpatient Services LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Richard Kwasi Agbeko Kessey | Internal Medicine | Cantrell Lake Inpatient Services LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Emem Udo | Hospitalist | Cantrell Lake Inpatient Services LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Gary J Rzeznik | Internal Medicine | Cantrell Lake Inpatient Services LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Robert J Holloway | Internal Medicine | Cantrell Lake Inpatient Services LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Street Address |
200 ALLEN MEMORIAL DR |
| City | BREMEN |
| State | GA |
| Zip | 30110-2012 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Odessa K Spraggins | Anesthesiology | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Gaston G Foderingham | Emergency Medicine | Independence Emergency Physicians LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Michael G Hamner | Anesthesiology | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Tracey M Ragsdale | Anesthesiology | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Janice K Bain | Internal Medicine | Cantrell Lake Inpatient Services LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Alexandre F Morin | Diagnostic Radiology | Georgia West Imaging PC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Natalie M Shields | Certified Registered Nurse Anesthetist (crna) | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Alyssia N Howard | Anesthesiology | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Jeffrey R Dishman | Certified Registered Nurse Anesthetist (crna) | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Michael B Eckert | Emergency Medicine | Independence Emergency Physicians LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Allison L Key | Family Medicine | 222 Gordon St, Bremen, GA 30110-1519 | |
| Steve Odeh | General Practice | 509 Alabama S Ave, Bremen, GA 30110-2007 | |
| Ralph J Templeton | Chiropractic | 507 Alabama Ave, Bremen, GA 30110-2007 | |
| Janice May Wilder | Nurse Practitioner | Bremen Family Health and Wellness | 509 Alabama S Ave, Bremen, GA 30110-2007 |
| Samuel L Ogden | Internal Medicine | 109 B Allen Memorial Dr, Bremen, GA 30110-2009 | |
| In Sook Kim | General Practice | Haralson Medical Clinic PC | 201 Allen Memorial Dr, Bremen, GA 30110-2011 |
| Pyung Kim | General Surgery | Haralson Medical Clinic PC | 201 Allen Memorial Dr, Bremen, GA 30110-2011 |
| David J Herren | Ophthalmology | Harbin Clinic LLC | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Bradley J.g. Larson | Hematology/oncology | Northwest Georgia Oncology Centers, PC | 200 Allen Memorial Dr, 302b, Bremen, GA 30110-2012 |
| Richard B Davis | Anesthesiology | Tmc-west Georgia Anesthesia Associates Inc. | 200 Allen Memorial Dr, Bremen, GA 30110-2012 |
| Find all physicians in zip 30110 | |||
| City | BREMEN |
| Zip Code | 30110 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | BREMEN + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Igor V Legostaev.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.