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NPI Code Detail

MEDICARE: DR. IVAYLO D STAYKOV M.D.

MEDICARE: DR. IVAYLO D STAYKOV 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
12084N0400XNeurology Physician0101236444VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00290770OTHERVAMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861497497
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IVAYLO D STAYKOV M.D.
Provider Business Mailing Address
First Line : 1970 ROANOKE BLVD
Second Line :
City : SALEM
State : VA
Zip : 24153-6404
Country : US
Telephone Number : 540-982-2463
Fax Number :
Provider Business Practice Location Address
First Line : 1970 ROANOKE BLVD
Second Line :
City : SALEM
State : VA
Zip : 24153-6404
Country : US
Telephone Number : 540-982-2463
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 08/28/2015

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