NPI 1003837410

Michael Mstislavovich Ivanitsky, MD

Practitioner Orthopaedic Surgery Physician Coquille, OR

Practice location

Address: 940 E 5th St, Coquille, OR 97423-1699
Phone: (541) 396-3111
Fax: (541) 396-8135
Mailing address: 940 E 5th St, Coquille, OR 97423-1666

Registered specialties

Orthopaedic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207X00000X Licence MD22589 (OR)

Other Orthopaedic Surgery providers in Oregon →

Registry record

NPI: 1003837410
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Jul 2006
Record last updated: 4 Sep 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.