Provider Demographics
NPI:1053517052
Name:SOROKHAN, VASYL (MD, PHD)
Entity type:Individual
Prefix:
First Name:VASYL
Middle Name:
Last Name:SOROKHAN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11651 NORBOURNE DR
Mailing Address - Street 2:APT. 1117
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-2100
Mailing Address - Country:US
Mailing Address - Phone:248-915-9646
Mailing Address - Fax:
Practice Address - Street 1:1295 KEMPER MEADOW DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-1633
Practice Address - Country:US
Practice Address - Phone:513-648-9077
Practice Address - Fax:513-345-6665
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.012895207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine