Slobodan Djordjevic in Grand Rapids - Physician Assistant
Slobodan Djordjevic - NPI 1790768802
Slobodan Djordjevic is a Physician Assistant in Grand Rapids, Michigan. Slobodan Djordjevic practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Slobodan Djordjevic is 1790768802. The last update date is 2007-07-08.
Slobodan Djordjevic's current location address is Po Box 152057, Grand Rapids, Michigan. You can contact this provider via phone number 6168855000 and fax number 6169139025. The mailing address for Slobodan Djordjevic is Po Box 152057, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Slobodan Djordjevic |
|---|---|
| Address | Po Box 152057, Grand Rapids, Michigan |
| Phone Number | 6168855000 |
| Fax Number | 6169139025 |
| Sole Proprietor | X |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1790768802 |
|---|---|
| Provider Enumeration Date | 2005-11-22 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | Po Box 152057 |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495152057 |
| Phone Number | 6168855000 |
| Fax Number | 6169139025 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 5601003454 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the unique identification code assigned to Slobodan Djordjevic by the Centers for Medicare & Medicaid Services?
The Slobodan Djordjevic has been issued the NPI (National Provider Identifier) 1790768802. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Slobodan Djordjevic?
The Slobodan Djordjevic is physically situated at Po Box 152057, in the city of Grand Rapids, state of MI, with the postal code 495152057.
What is the Slobodan Djordjevic's area of specialization and corresponding taxonomy classification?
The Slobodan Djordjevic's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
When did Slobodan Djordjevic receive its 1790768802 assignment?
The Slobodan Djordjevic was assigned its 1790768802 on 2005-11-22, which is the date when this unique identifier was issued to the organization.
When was the Slobodan Djordjevic's information last updated?
The Slobodan Djordjevic's information was last updated on 2007-07-08.