Provider Demographics
NPI:1104965698
Name:SCHERBAKOV, EFIM (LMT, LPTA)
Entity type:Individual
Prefix:MR
First Name:EFIM
Middle Name:
Last Name:SCHERBAKOV
Suffix:
Gender:M
Credentials:LMT, LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 BROOKRUN DR
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-1374
Mailing Address - Country:US
Mailing Address - Phone:330-808-0661
Mailing Address - Fax:
Practice Address - Street 1:83 N MILLER RD STE 104
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3729
Practice Address - Country:US
Practice Address - Phone:330-808-0661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA .03673174400000X
OHLMT 33. 009335174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist