Khimenko, Pavel L

Khimenko, Pavel L is an sole proprietor health care provider with primary practice located at 4211 Hospital St Suite 107, Pascagoula MS 39581-5310. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Khimenko, Pavel L can be contacted via phone (228) 202-3335.

Contact Information

Primary practice address
4211 Hospital St Suite 107 Pascagoula MS 39581-5310
Phone: (228) 202-3335
Fax: (228) 202-3337
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 18035 Mississippi

Profile Details

NPI number 1548241904
LBN Legal business name Khimenko, Pavel L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 10th, 2005
Last updated Jan 18th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548241904 NPPES
Mississippi MEDICAID 00120919

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