Provider Demographics
NPI:1992721658
Name:ZUBKOV, ALEXANDER Y (MD, PHD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:Y
Last Name:ZUBKOV
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 1:3400 W 66TH ST
Mailing Address - Street 2:STE 150
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2109
Mailing Address - Country:US
Mailing Address - Phone:952-920-7200
Mailing Address - Fax:763-302-4234
Practice Address - Street 1:3400 W 66TH ST
Practice Address - Street 2:STE 150
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2109
Practice Address - Country:US
Practice Address - Phone:952-920-7200
Practice Address - Fax:763-302-4234
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-119452084N0400X
MS187602084N0400X
TN584432084N0400X
MN490912084V0102X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1047901OtherPREFERRED ONE
MN2443538OtherAMERICA'S PPO
MNHP66003OtherHEALTHPARTNERS
MN1992721658Medicaid
MN443A6ZUOtherBCBS OF MN
MN135602C029OtherUCARE
MNP00387576OtherRAILROAD MEDICARE
MN0500854OtherMEDICA
WI34884300Medicaid
MN0500854OtherMEDICA
MN2443538OtherAMERICA'S PPO