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Gennady G Miroshnichenko, MD
Gynecologic Oncology Physician in Fort Worth, Texas
NPI 1164784450

Gennady G Miroshnichenko is a Gynecologic Oncology Physician based in Dallas, TX and is specialized in Gynecologic Oncology. Gennady G Miroshnichenko practices in Fort Worth, TX and has the professional credentials of MD. The NPI Number for Gennady G Miroshnichenko is 1164784450 and holds a License No. P4595 (Texas).

The current practice location address for Gennady G Miroshnichenko is 1201 S Main St, Fort Worth, TX and can be reached out via phone at 817-702-6500 and via fax at 817-702-6561.

Location: 1201 S Main St, Fort Worth, TX, 75373-2973
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164784450
Provider Name
Gennady G Miroshnichenko
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1201 S Main St, Fort Worth, TX, 75373-2973
Phone Number
817-702-6500
Fax Number
817-702-6561
Provider Enumeration Date
06/12/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
307460101 05 TX
8DM684 01 TX BCBS
institution
Provider Business Practice Location Address Details
Address
1201 S Main St
City
Fort Worth
State
Texas
Zip
76104-4804
Phone Number
817-702-6500
Fax Number
817-702-6561
person
Provider Business Mailing Address Details
Address
1201 S Main St
City
Fort Worth
State
Texas
Zip
76104-4804
Phone Number
817-702-6500
Fax Number
817-702-6561
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
-
Taxonomy
207V00000X
License No.
P4595 (Texas)
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
Gynecologic Oncology
Taxonomy
207VX0201X
License No.
P4595 (Texas)
Definition
An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.
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