1740786755 NPI number — MRS. SLAVICA GJORGJEVSKA-SMILJKOVICH MD

Table of content: RINU ANN DANIEL ATP (NPI 1407655475)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740786755 NPI number — MRS. SLAVICA GJORGJEVSKA-SMILJKOVICH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GJORGJEVSKA-SMILJKOVICH
Provider First Name:
SLAVICA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GJORGJEVSKA
Provider Other First Name:
SLAVICA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740786755
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30795 23 MILE RD.
Provider Second Line Business Mailing Address:
SUITE #202
Provider Business Mailing Address City Name:
CHESTERFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48047
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-421-1740
Provider Business Mailing Address Fax Number:
586-421-1744

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30795 23 MILE RD.
Provider Second Line Business Practice Location Address:
SUITE #202
Provider Business Practice Location Address City Name:
CHESTERFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-421-1740
Provider Business Practice Location Address Fax Number:
586-421-1744
Provider Enumeration Date:
03/30/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  4301502456 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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