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General NPI Number Information
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NPI Number | 1033173471
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Entity Type | Individual
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Provider Name | MIKHAIL J ARTAMONOV M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 391 E BROWN ST
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-9101
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Country | US
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Telephone | 570-872-9800
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Fax | 570-872-9888
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Provider Business Mailing Address
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Address Line | 391 E BROWN ST
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-9101
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Country | US
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Telephone | 570-872-9800
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Fax | 570-872-9888
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | MD484898
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD484898
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 250059
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2081P0301X
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Taxonomy Name | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | MD484898
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | MD484898
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | ME100837
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License Number State | FL
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