GENNADIY VASILYEVICH SHEVCHENKO


Address: 3809 42nd Ave S, Minneapolis, MN 55406-3503
Phone: 6127216261

GENNADIY VASILYEVICH SHEVCHENKO (NPI# 1093005498) 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) 1093005498
Entity Type Individual
Full Name GENNADIY VASILYEVICH SHEVCHENKO
Credential MD
Practice Address 3809 42nd Ave S
Minneapolis
MN 55406-3503
Practice Telephone 6127216261
Practice Fax Number 6127211691
Mailing Telephone 6127216261
Mailing Fax Number 6127211691
Enumeration Date 2011-04-19
Last Update Date 2016-08-22
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084N0400X Psychiatry & Neurology
Specialization: Neurology
59255 MN Allopathic & Osteopathic Physicians

Office Location

Street Address 3809 42ND AVE S
City MINNEAPOLIS
State MN
Zip Code 55406-3503

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972579670 Angela Dhruvan Family Medicine 3809 42nd Ave S, Minneapolis, MN 55406-3503 2006-02-23
1124438734 Marissa Drake Registered Nurse 3809 42nd Ave S, Minneapolis, MN 55406-3503 2014-05-05
1689010357 Jodi Lynn Johnson Registered Nurse 3809 42nd Ave S, Minneapolis, MN 55406-3503 2013-05-21
1780942078 Deqa Yassin Mohamed Family Medicine 3809 42nd Ave S, Minneapolis, MN 55406 2012-04-25
1538492103 Jennifer Lynn Nickell Pharmacist 3809 42nd Ave S, Minneapolis, MN 55406-3503 2009-09-14
1598921108 Katharine Jones Plosser Physician Assistant 3809 42nd Ave S, Minneapolis, MN 55406-3503 2008-08-03
1922271857 Sandeep Kalola Family Medicine 3809 42nd Ave S, Minneapolis, MN 55406-3503 2008-04-11
1346432218 Fairview Clinics Clinic/Center 3809 42nd Ave S, Minneapolis, MN 55406-3503 2007-08-15
1932328226 Louisa Paul Family Medicine 3809 42nd Ave S, Minneapolis, MN 55406-3503 2007-04-24
1851436539 Fairview Hiawatha Pharmacy Mtm Non-Pharmacy Dispensing Site 3809 42nd Ave S, Minneapolis, MN 55406-3503 2007-02-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1689286221 Hoa Bui Pharmacist 4547 Hiawatha, Minneapolis, MN 55406 2020-08-17
1184263253 Carrie Shannon Nightshade Acupuncturist 3706 E 42nd Street, Minneapolis, MN 55406 2020-01-06
1164060059 Deborah Owen Acupuncturist 3706 E 42nd St, Minneapolis, MN 55406 2019-12-11
1194290593 Noelle Therese Wolf Counselor 2637 27th Ave S # 229, Minneapolis, MN 55406 2018-10-11
1255819819 Ayan Osman Ali Behavior Technician 3355 Haiwatha Ave Suite 100, Minneapolis, MN 55406 2018-08-04
1881188597 Lydia Joy Allison Massage Therapist 2933 29th Ave. S., Minneapolis, MN 55406 2018-06-15
1497261770 Carroll Lee Beaty Massage Therapist 2801 42nd Ave. So., Minneapolis, MN 55406 2017-12-21
1578082798 Capitol Cafe LLC Home Delivered Meals 2417 E Franklin Ave, Capitol Cafe, Minneapolis, MN 55406 2017-09-19
1851823942 Safia Abdulkadir Mohamud Contractor 2740 Minnehaha Ave Suit 100, Minneapolis, MN 55406 2017-03-29
1881051944 Sos Transportation LLC Non-emergency Medical Transport (VAN) 3355 Haiwatha Ave Suit 100, Minneapolis, MN 55406 2016-01-20
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Taxonomy Information

Taxonomy Code 2084N0400X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Neurology

Taxonomy Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669995528 Malik Ghannam Psychiatry & Neurology 701 15th Ave Se, Minneapolis, MN 55414-4047 2017-07-24
1477903995 James Albert Zeese Jr. Psychiatry & Neurology 2401 Laurel Avenue, Minneapolis, MN 55405 2016-06-15
1699079533 Gilbert Westreich Psychiatry & Neurology 1779 Emerson Ave South, Minneapolis, MN 55403-2909 2011-01-07
1801089024 Bruce Merrtill Tennebaum Psychiatry & Neurology 3812 Zenith Ave S, Minneapolis, MN 55410-1167 2007-08-21
1942355490 Adam Forbes Carpenter Psychiatry & Neurology 420 Delaware St Se, Clinic 1a, Phillips Wangensteen Building, Minneapolis, MN 55455 2007-01-24
1821172123 John Riley Mccarten Psychiatry & Neurology One Veterans' Drive Minneapolis Vamc, Geriatric Research Education and Clinical Center, 11-g, Minneapolis, MN 55417 2006-10-24
1811085137 Paul J Tuite Psychiatry & Neurology Pwb First Floor, Clinic 1a, 516 Delaware Street Se, Minneapolis, MN 55455 2006-10-11
1326143553 Scott Mitchell Lewis Psychiatry & Neurology 1 Veterans Dr # 11b, Minneapolis, MN 55417-2309 2006-09-13
1649372350 David Allan Rottenberg Psychiatry & Neurology 516 Delaware Street Se, Clinic 1a, Neurology Clinic, Minneapolis, MN 55455-0346 2006-09-02
1538174073 Ilo Elmar Leppik Psychiatry & Neurology 5775 Wayzata Blvd Ste 200, Minneapolis, MN 55416-1227 2006-07-31
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Competitor

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City MINNEAPOLIS
Zip Code 55406

Improve Information

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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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