Individual
DEJAN ZIVKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
850 COLUMBIA RD, WESTLAKE, OH 44145-1493
(440) 808-4000
Mailing address
PO BOX 567, CHAGRIN FALLS, OH 44022-0567
(216) 464-5160
(216) 464-5982
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
67000093
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2375522
—
OH
Enumeration date
08/10/2005
Last updated
03/17/2008
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