DMITRIY STALIVONENKO

KENOSHA, WI
NPI1710966395
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: WI  40879-020)
Enumeration Date2006-01-12
Last Update Date2023-11-06
Business Address
Dr. DMITRIY STALIVONENKO M.D.
10400 75TH ST
KENOSHA, WI 53142-7884
Phone number: 414-358-5443
Mailing Address
Dr. DMITRIY STALIVONENKO M.D.
PO BOX 735044
CHICAGO, IL 60673-5044
Phone number: 414-358-5443
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