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NPI Code Detail

MEDICARE: DR. MAXIM ALEXANDER ZLATOPOLSKY MD

MEDICARE: DR. MAXIM ALEXANDER ZLATOPOLSKY MD
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
1207R00000XInternal Medicine Physician4301500775MI
2207R00000XInternal Medicine Physician35.140040OH

General Provider Information

NPI Number : 1851820203
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAXIM ALEXANDER ZLATOPOLSKY MD
Provider Business Mailing Address
First Line : 22 TURTLE CREEK CIR
Second Line :
City : SWANTON
State : OH
Zip : 43558-8591
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 22 TURTLE CREEK CIR
Second Line :
City : SWANTON
State : OH
Zip : 43558-8591
Country : US
Telephone Number : 419-825-5151
Fax Number : 419-825-5901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2017
Last Update Date : 08/02/2021

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