Basic Information
| Provider Information | |||||||||
| NPI: | 1851304455 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILSTEIN | ||||||||
| FirstName: | VLADIMIR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1867 REMOUNT RD | ||||||||
| Address2: | SUITE H | ||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280547401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048653848 | ||||||||
| FaxNumber: | 7048543086 | ||||||||
| Practice Location | |||||||||
| Address1: | 1867 REMOUNT RD | ||||||||
| Address2: | SUITE H | ||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280547401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048653848 | ||||||||
| FaxNumber: | 7048543086 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2006 | ||||||||
| LastUpdateDate: | 12/26/2013 | ||||||||
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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 | 2084P0800X | 166292 | NY | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 9400937 | NC | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 5920144 | 05 | NC | MEDICAID | 01783348 | 05 | NY | MEDICAID |