Individual
NATHAN VANDJELOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4201 SAINT ANTOINE ST # 9C, DETROIT, MI 48201-2153
(313) 745-5147
(313) 966-0880
Mailing address
875S BRYS DR, GROSSE POINTE WOODS, MI 48236-1209
(804) 929-2964
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
5101020558
MI
2080P0214X
Pediatric Pulmonology Physician
297940
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/03/2013
Last updated
06/30/2023
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