Basic Information
| Provider Information | |||||||||
| NPI: | 1316177157 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SINYAVSKIY | ||||||||
| FirstName: | OLEG | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 468 CADIEUX RD | ||||||||
| Address2: | |||||||||
| City: | GROSSE POINTE WOODS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482301507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3133431000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 36115 SCHOOLCRAFT RD | ||||||||
| Address2: | |||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481501216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344640887 | ||||||||
| FaxNumber: | 7344020254 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2009 | ||||||||
| LastUpdateDate: | 04/13/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301093752 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 304889 | LA | N | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 0H208910 | 01 | MI | BCBSM GROUP | OTHER | 700E012740 | 01 | MI | BCBSM GROUP | OTHER |