Provider Demographics
NPI:1083844542
Name:PROKOPIV, HALYNA (MD)
Entity Type:Individual
Prefix:
First Name:HALYNA
Middle Name:
Last Name:PROKOPIV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5989 WEISS ST
Mailing Address - Street 2:APT - L-10
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2713
Mailing Address - Country:US
Mailing Address - Phone:989-980-6092
Mailing Address - Fax:
Practice Address - Street 1:5989 WEISS ST
Practice Address - Street 2:APT - L-10
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2713
Practice Address - Country:US
Practice Address - Phone:989-980-6092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-18
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036137026207R00000X
MI4301090211207R00000X
WI63510208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine