Individual
KAROLYN M IVANOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12936 N COBBLESTONE CT, MEQUON, WI 53097-1813
(612) 573-2200
(612) 573-2274
Mailing address
7595 ANAGRAM DR, EDEN PRAIRIE, MN 55344-7399
(612) 573-2200
(612) 573-2274
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
47884
MN
2085R0202X
Diagnostic Radiology Physician
52808
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457337867
—
WI
Enumeration date
12/16/2005
Last updated
12/05/2024
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