Individual
DR. PETAR MIHAJLO ILIEVSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
612 N 13TH ST, ARTESIA, NM 88210-1112
(575) 748-8311
(575) 736-6352
Mailing address
PO BOX 629, ARTESIA, NM 88211-0629
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
29489
IA
208800000X
Urology Physician
Primary
MD2011-0017
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0443457
—
IA
01
—
37336
BLUE CROSS /BLUE SHIELD
IA
01
—
IA0132
JOHN DEER
IA
Enumeration date
02/08/2006
Last updated
07/01/2011
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