Basic Information
Provider Information
NPI: 1811909278
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HNATIUK
FirstName: OLEH
MiddleName: WASYL
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherLastNameType:  
Mailing Information
Address1: 933 BRADBURY DR SE
Address2: SUITE 2222
City: ALBUQUERQUE
State: NM
PostalCode: 871064374
CountryCode: US
TelephoneNumber: 5052723120
FaxNumber: 5052728060
Practice Location
Address1: 1 UNIVERSITY OF NEW MEXICO
Address2: MSC10-5550
City: ALBUQUERQUE
State: NM
PostalCode: 871310001
CountryCode: US
TelephoneNumber: 5052724751
FaxNumber: 5052728700
Other Information
ProviderEnumerationDate: 08/13/2006
LastUpdateDate: 06/01/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XMD2015-0925NMY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RS0012XMD2015-0925NMN Allopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
207R00000XMD2015-0925NMN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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