Most Relevant Information
Provider Data
| NPI Number: | 1003076456 |
| Provider Name: | VITALY KISHINYOVSKY MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207Q00000X |
| Specialty: | Family Medicine |
| License Number: | 116020178 |
Most Important Dates
| Enumeration Date: | 06/10/2008 |
| Last Updated: | 06/10/2008 |
Provider Practice Location
2145 MOUNT PLEASANT BLVD SE
ROANOKE
VA
240143632
Practice Location Phone/Fax
| Phone: | 5404279200 |
| Fax: |
Provider Mailing Location
2145 MOUNT PLEASANT BLVD SE
ROANOKE
VA
240143632
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |
Suggested EMR
Family Practice EMR