Provider Demographics
NPI:1467560300
Name:VEKSTEIN, VLADIMIR (MD)
Entity Type:Individual
Prefix:MR
First Name:VLADIMIR
Middle Name:
Last Name:VEKSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 MAYFIELD ROAD
Mailing Address - Street 2:SUITE 444
Mailing Address - City:MAYFIELD HGTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2209
Mailing Address - Country:US
Mailing Address - Phone:440-449-8890
Mailing Address - Fax:440-449-7580
Practice Address - Street 1:6801 MAYFIELD ROAD
Practice Address - Street 2:SUITE 444
Practice Address - City:MAYFIELD HGTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2209
Practice Address - Country:US
Practice Address - Phone:440-449-8890
Practice Address - Fax:440-449-7580
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 060449207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH34192070200OtherBWC
OH000000142194OtherANTHEM
OH0895741Medicaid
OH2382067OtherAETNA HMO
OH4300182OtherAETNA NON-HMO
E 85010Medicare UPIN
VE 0685084Medicare ID - Type Unspecified
OHVE0685084Medicare PIN