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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
59255 | MN | Allopathic & Osteopathic Physicians |
Street Address |
3809 42ND AVE S |
City | MINNEAPOLIS |
State | MN |
Zip Code | 55406-3503 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 55406 |
Taxonomy Code | 2084N0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology |
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] |
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 |
Find all providers in MINNEAPOLIS |
City | MINNEAPOLIS |
Zip Code | 55406 |
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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.