Organization
STEVANOVIC CLINICS SC
Active
Organization
STEVANOVIC CLINICS SC
Active
Other names
Stevanovic Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEBOJSA STEVANOVIC MD (MD)
(414) 546-8000
Entity
Organization
Contact information
Practice address
11111 W OKLAHOMA AVE, WEST ALLIS, WI 53227-4033
(414) 546-8000
(414) 546-2909
Mailing address
11111 W OKLAHOMA AVE, WEST ALLIS, WI 53227-4033
(414) 546-8000
(414) 546-2909
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
39372
WI
332B00000X
Durable Medical Equipment & Medical Supplies
39372
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001299
PTAN
WI
05
—
32398100
—
WI
Enumeration date
02/14/2006
Last updated
07/18/2013
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