Individual
MLADEN PREMUZIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 IRVING ST NW, WASHINGTON, DC 20010-2976
(301) 946-5100
(301) 929-0348
Mailing address
11510 GEORGIA AVE, SUITE 206, WHEATON, MD 20902-1925
(301) 946-5100
(301) 929-0348
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD30003
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0094
CAREFIRST BCBS
DC
01
—
200138
KAISER
DC
01
—
2495295
AETNA HMO
DC
01
—
441052
ANTHEM BCBS
VA
01
—
501345
NCPPO
DC
05
—
5705011
—
VA
01
—
5983731
AETNA NON HMO
DC
Enumeration date
07/14/2006
Last updated
07/09/2007
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