DR. Michael Mstislavovich Ivanitsky, MD

NPI #1003837410 in Coquille, Oregon

Provider Information

NPI Number: 1003837410
Entity Type: Individual
Name: DR. Michael Mstislavovich Ivanitsky, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Orthopaedic Surgery
Credential: MD
Enumeration Date: Jul 21, 2006
Last Updated: Sep 4, 2020

Practice Location

Address: 940 E 5TH ST
City: Coquille
State: Oregon
ZIP Code: 97423-1699
Phone: (541) 396-3111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X	Primary

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