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1205306545
VADIM SELYUKOV
PHILADELPHIA, PA
NPI
1205306545
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: PA SP019675)
Enumeration Date
2018-11-29
Last Update Date
2019-06-27
Business Address
VADIM SELYUKOV
8815 GERMANTOWN AVE STE 16
PHILADELPHIA, PA 19118-2722
Phone number: 215-242-1159
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Mailing Address
VADIM SELYUKOV
1102 LITTLE LN
WARMINSTER, PA 18974-1963
Phone number:
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