Provider Demographics
NPI:1497919633
Name:VICTOR V KOPYEV, MD, LLC
Entity Type:Organization
Organization Name:VICTOR V KOPYEV, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPYEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-673-8708
Mailing Address - Street 1:1949 STATE ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-8124
Mailing Address - Country:US
Mailing Address - Phone:330-673-0505
Mailing Address - Fax:
Practice Address - Street 1:1949 STATE ROUTE 59
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-8124
Practice Address - Country:US
Practice Address - Phone:330-673-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074815207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty