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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