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Individual

MR. DEJAN LUKOVIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ACNP

Contact information

Practice address
203 MILLS AVE, GREENVILLE, SC 29605-4019
(864) 271-1844
Mailing address
203 MILLS AVE, GREENVILLE, SC 29605-4019
(864) 271-1844

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
21836
SC

Other

Enumeration date
04/20/2018
Last updated
04/20/2018
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