| Doctor Name: | DR. SLAVA M BELENKIY |
| NPI Number: | 1104893338 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 01059902A |
| Business Practice Address: | 1061 Harmon Ave Ste 1d03 Ft Stewart, GA - 313145604 |
| Business Phone Number: | 9124356933 |
| Business Fax Number: | 9124355966 |
| Mailing Address: | 1061 Harmon Ave, Ste 1d03 FT STEWART |
| State: | GA |
| Postal Code: | 313145604 |
| Phone Number: | 9124356933 |
| Fax Number: | 9124355966 |
| NPI Enumeration Date: | 03/07/2006 |
| NPI Last Update Date: | 12/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01059902A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |