Provider Demographics
NPI:1093949158
Name:PISHCHIK, VITALIY
Entity Type:Individual
Prefix:DR
First Name:VITALIY
Middle Name:
Last Name:PISHCHIK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 QUARRY LAKES DRIVE
Mailing Address - Street 2:CLEVELAND CLINIC CANCER CENTERS
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870
Mailing Address - Country:US
Mailing Address - Phone:419-609-2870
Mailing Address - Fax:
Practice Address - Street 1:417 QUARRY LAKES DRIVE
Practice Address - Street 2:CLEVELAND CLINIC CANCER CENTERS
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870
Practice Address - Country:US
Practice Address - Phone:419-609-2870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.096330207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology