Provider Demographics
NPI:1669577870
Name:DUBCHUK, VLADIMIR (MD)
Entity type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:DUBCHUK
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 1:7215 OLD OAK BLVD
Mailing Address - Street 2:SUITE A314
Mailing Address - City:MIDDLEBURG HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130
Mailing Address - Country:US
Mailing Address - Phone:440-816-5500
Mailing Address - Fax:440-816-5514
Practice Address - Street 1:7215 OLD OAK BLVD
Practice Address - Street 2:SUITE A314
Practice Address - City:MIDDLEBURG HTS
Practice Address - State:OH
Practice Address - Zip Code:44130
Practice Address - Country:US
Practice Address - Phone:440-816-5500
Practice Address - Fax:440-816-5514
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083144D208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I07045Medicare UPIN