Individual
DONALD E MRDJENOVICH
Active
Individual
DONALD E MRDJENOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
SC003403L
PA
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
SC0034031
PA
213ER0200X
Radiology Podiatrist
SC003403L
PA
213ES0131X
Foot Surgery Podiatrist
SC003403L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000087405
UNISON
PA
01
—
000680859
KEYSTONE HEALTH PLAN
PA
05
—
0016415200001
—
PA
05
—
0016415200002
—
PA
01
—
0707106
AETNA HMO QPOS
PA
01
—
1024439
GATEWAY INDIVIDUAL
PA
01
—
206170
UPMC
PA
01
—
21139415759
BEECH STREET
PA
01
—
251775206
TAX ID FOR GROUP
—
01
—
480019774
RAILROAD MEDICARE INDIVID
PA
01
—
5082453
PPNI
PA
01
—
740952
FOCUS
PA
01
—
826758
BLUE SHIELD GROUP
PA
01
—
CC2226
RAILROAD MEDICARE GROUP
PA
01
—
MR680859
BLUE SHIELD IND
PA
01
—
P11111021
MULTIPLAN
PA
Enumeration date
01/09/2006
Last updated
05/05/2011
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