Provider Demographics
NPI:1740321298
Name:SVESKO, VLADIMIR
Entity type:Individual
Prefix:DR
First Name:VLADIMIR
Middle Name:
Last Name:SVESKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W UNIVERSITY AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3114
Mailing Address - Country:US
Mailing Address - Phone:928-774-1693
Mailing Address - Fax:928-774-3533
Practice Address - Street 1:1200 N BEAVER ST
Practice Address - Street 2:FLAGSTAFF MEDICAL CENTER
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3115
Practice Address - Country:US
Practice Address - Phone:928-214-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8802207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine