Individual
DJORDJE HRISTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5495 S RAINBOW BLVD STE 101, LAS VEGAS, NV 89118-1872
(702) 477-0772
Mailing address
PO BOX 30077, DEPT 305, SALT LAKE CITY, UT 84130-0077
(877) 243-8416
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
8834
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152975
WC
NV
01
—
153099
WC
NV
05
—
200290123
—
NV
01
—
NV1615
BCBS
NV
01
—
NV7149
BCBS
NV
Enumeration date
05/15/2006
Last updated
10/20/2017
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