Pustynovich, Vadim P

Pustynovich, Vadim P is an individual health care provider with primary practice located at 700 W Ironwood Dr Ste 120 , Coeur D Alene ID 83814-4405. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Pustynovich, Vadim P can be contacted via phone (208) 625-3640.

Contact Information

Primary practice address
700 W Ironwood Dr Ste 120 Coeur D Alene ID 83814-4405
Phone: (208) 625-3640
Fax: (208) 625-3645
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 26NJ01002700 New Jersey
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP66228 Idaho

Profile Details

NPI number 1518507086
LBN Legal business name Pustynovich, Vadim P
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2020
Last updated Apr 24th, 2024 - about last year

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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