Provider Demographics
NPI:1134276736
Name:MIKHAYLOVSKIY, ALEKSANDR VLADIMIROVICH (MD)
Entity type:Individual
Prefix:DR
First Name:ALEKSANDR
Middle Name:VLADIMIROVICH
Last Name:MIKHAYLOVSKIY
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 1:575 COAL VALLEY RD
Mailing Address - Street 2:277
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3730
Mailing Address - Country:US
Mailing Address - Phone:412-469-7722
Mailing Address - Fax:412-469-7721
Practice Address - Street 1:575 COAL VALLEY RD
Practice Address - Street 2:277
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3730
Practice Address - Country:US
Practice Address - Phone:412-469-7722
Practice Address - Fax:412-469-7721
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010804102081P2900X
PAMD4309102081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1398027OtherBS
PA1019157610001Medicaid
PA1941855OtherBSPA
PAP00413440Medicare PIN
060201Medicare PIN
PAI71624Medicare UPIN
PA1941855OtherBSPA
DB1418Medicare PIN