MEDICARE: DR. VLADIMIR K MOSKVER M.D.

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	207Q00000X	Family Medicine Physician	32046	CO

General Provider Information

NPI Number	:	1336125962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VLADIMIR K MOSKVER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 9900
Second Line	:
City	:	BRECKENRIDGE
State	:	CO
Zip	:	80424-9021
Country	:	US
Telephone Number	:	719-633-1937
Fax Number	:

Provider Business Practice Location Address
First Line	:	53 AUDREY CIR
Second Line	:
City	:	BRECKENRIDGE
State	:	CO
Zip	:	80424-8950
Country	:	US
Telephone Number	:	719-633-1937
Fax Number	:

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	08/24/2009

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