Healthcare Provider Details

I. General information

NPI: 1538084934
Provider Name (Legal Business Name): MR. VLADIMIR SHEYNMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 PALMETTO GLEN DR
MYRTLE BEACH SC
29588-1195
US

IV. Provider business mailing address

111 PALMETTO GLEN DR
MYRTLE BEACH SC
29588-1195
US

V. Phone/Fax

Practice location:
  • Phone: 732-767-9470
  • Fax:
Mailing address:
  • Phone: 732-767-9470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: