MEDICARE: NATALYA SHLYAKHOVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	62357	MN
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A134109	CA
3	390200000X	Student in an Organized Health Care Education/Training Program
4	207ZP0101X	Anatomic Pathology Physician	62357	MN

General Provider Information

NPI Number	:	1750725420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALYA SHLYAKHOVA

Provider Business Mailing Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-0001
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-5201
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2013
Last Update Date	:	07/21/2022

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Directions to “ NATALYA SHLYAKHOVA ” Practice Location

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