Healthcare Provider Details

I. General information

NPI: 1699791814
Provider Name (Legal Business Name): OKSANA VOLSHTEYN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 11/15/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 PARKVIEW PL DIV NEUROLOGY NEUROREHABILITATION, STE 6C
SAINT LOUIS MO
63110-1032
US

IV. Provider business mailing address

660 S EUCLID AVE CB 8518
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-1408
  • Fax: 314-362-4566
Mailing address:
  • Phone: 314-362-1408
  • Fax: 314-362-4566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License NumberR2E86
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberR2E86
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: