Artyom Vladimir Vlasenko, M.D.
Individual provider Active NPI General Practice Physician · Svannah, GA
NPI 1538522784 · NPPES record last updated Mar 21, 2019
Key facts
- NPI
- 1538522784
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 82177 (GA)
- Practice address
- 1101 Lexington Ave
Center for Internal Medicine
Svannah, GA 31404 - Phone
- (912) 350-7171
- NPI assigned
- Apr 4, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82177 | GA | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Physician | 208D00000X | 82177 | GA | Yes |
Addresses
Primary practice location
1101 Lexington Ave
Center for Internal Medicine
Svannah, GA 31404
Mailing address
4700 Waters Ave
Department of Internal Medicine Education
Savannah, GA 31404-6220
Phone (912) 350-7173
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.