Provider Demographics
NPI:1508014721
Name:BROWN-ZHELTKOV, VLADIMIR A (MD)
Entity Type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:A
Last Name:BROWN-ZHELTKOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:VLADIMIR
Other - Middle Name:A
Other - Last Name:ZHELTKOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 ARH LANE
Mailing Address - Street 2:SUITE 202A
Mailing Address - City:LOW MOOR
Mailing Address - State:VA
Mailing Address - Zip Code:24457
Mailing Address - Country:US
Mailing Address - Phone:540-862-2021
Mailing Address - Fax:540-862-7284
Practice Address - Street 1:1 ARH LANE
Practice Address - Street 2:SUITE 202A
Practice Address - City:LOW MOOR
Practice Address - State:VA
Practice Address - Zip Code:24457-2419
Practice Address - Country:US
Practice Address - Phone:540-862-2021
Practice Address - Fax:540-862-7284
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0524702084P0800X
VA01012578792084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1508014721Medicaid
VA1508014721Medicaid
VAP01707793Medicare PIN