Provider Demographics
NPI:1245893270
Name:NEVEROV, NIKITA IGOREVICH (MD)
Entity type:Individual
Prefix:DR
First Name:NIKITA
Middle Name:IGOREVICH
Last Name:NEVEROV
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Gender:M
Credentials:MD
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Mailing Address - Street 1:501 HOWARD AVE STE D204
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4814
Mailing Address - Country:US
Mailing Address - Phone:814-944-2107
Mailing Address - Fax:814-944-6208
Practice Address - Street 1:501 HOWARD AVE STE D204
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4814
Practice Address - Country:US
Practice Address - Phone:814-944-2107
Practice Address - Fax:814-944-6208
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC122720207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology