Provider Demographics
NPI:1659481455
Name:GELFENBEYN, MIKHAIL SEMENOVICH (MD)
Entity Type:Individual
Prefix:
First Name:MIKHAIL
Middle Name:SEMENOVICH
Last Name:GELFENBEYN
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 1:1660 S. COLUMBIAN WAY
Mailing Address - Street 2:SURGICAL SERVICE 112-NS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108
Mailing Address - Country:US
Mailing Address - Phone:206-543-0065
Mailing Address - Fax:206-764-2753
Practice Address - Street 1:1660 S. COLUMBIAN WAY
Practice Address - Street 2:SURGICAL SERVICE 112-NS
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108
Practice Address - Country:US
Practice Address - Phone:206-543-0065
Practice Address - Fax:206-764-2753
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60112267207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery