Healthcare Provider Details

I. General information

NPI: 1659831832
Provider Name (Legal Business Name): MIKHAIL A. RASSOKHIN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 GLENN MITCHELL DR
VIRGINIA BEACH VA
23456-0178
US

IV. Provider business mailing address

4713 BERRYWOOD RD
VIRGINIA BEACH VA
23464-5869
US

V. Phone/Fax

Practice location:
  • Phone: 757-252-3047
  • Fax:
Mailing address:
  • Phone: 757-337-9748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101275559
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101275559
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: