Provider Demographics
NPI:1346217809
Name:MIKHAIL O. CHIZHIKOV, MD, LLC
Entity Type:Organization
Organization Name:MIKHAIL O. CHIZHIKOV, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:O
Authorized Official - Last Name:CHIZHIKOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-799-3310
Mailing Address - Street 1:1045 MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1800
Mailing Address - Country:US
Mailing Address - Phone:434-799-3310
Mailing Address - Fax:434-799-3317
Practice Address - Street 1:1045 MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1800
Practice Address - Country:US
Practice Address - Phone:434-799-3310
Practice Address - Fax:434-799-3317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012269712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty