Provider Demographics
NPI:1447248794
Name:VOROSHILOVA, OLGA (MD)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:VOROSHILOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1662 MARS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3825
Mailing Address - Country:US
Mailing Address - Phone:216-712-6556
Mailing Address - Fax:216-712-6596
Practice Address - Street 1:224 W EXCHANGE ST STE 330
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1715
Practice Address - Country:US
Practice Address - Phone:330-436-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10635207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0107602Y0NH01OtherANTHEM
OH0489817Medicaid
NH30200256Medicaid
NHG95474OtherHARVARD PILGRIM
NHQX3345OtherMEDICARE PTAN