Provider Demographics
NPI:1952924128
Name:RYBIN, PAVEL ALEXANDROVICH (PA-C)
Entity type:Individual
Prefix:
First Name:PAVEL
Middle Name:ALEXANDROVICH
Last Name:RYBIN
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2520 ABERDEEN BLVD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0635
Mailing Address - Country:US
Mailing Address - Phone:704-868-8400
Mailing Address - Fax:
Practice Address - Street 1:2520 ABERDEEN BLVD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0635
Practice Address - Country:US
Practice Address - Phone:704-868-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant