Organization
MIDWAY MEDICAL CLINIC STEVEN P. RADJENOVICH D.O. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN PERL RADJENOVICH D.O. (PRESIDENT)
(320) 763-6452
Entity
Organization
Contact information
Practice address
119 30TH AVE W, ALEXANDRIA, MN 56308-3433
(320) 763-6452
(320) 763-2971
Mailing address
119 30TH AVE W, ALEXANDRIA, MN 56308-3433
(320) 763-6452
(320) 763-2971
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22233
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
449883600
—
MN
Enumeration date
09/27/2005
Last updated
01/31/2013
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