Basic Information
| Provider Information | |||||||||
| NPI: | 1689656423 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRASLAVSKY | ||||||||
| FirstName: | VADIM | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7812 W 147TH TER | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662231185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136857494 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5721 W 119TH ST | ||||||||
| Address2: | EMERGENCY DEPARTMENT | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662093722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9134691488 | ||||||||
| FaxNumber: | 9134691441 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 424828 | KS | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.