Individual
LANA CANKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
51 ROSELANE STREET NW, SUITE 750, MARIETTTA, GA 30060
(770) 794-0477
(770) 794-3108
Mailing address
51 ROSELANE STREET NW, SUITE 750, MARIETTTA, GA 30060
(770) 794-0477
(770) 794-3108
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
055186
GA
207L00000X
Anesthesiology Physician
25350
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009947365
—
AL
05
—
009949135
—
AL
01
—
010033CH72657
SECTION 1011
AL
01
—
051520796
BLUE CROSS
AL
01
—
051520797
BLUE CROSS
AL
01
—
051520798
BLUE CROSS
AL
01
—
07833224
MISSISSIPPI MEDICAID
MS
01
—
P00215395
RAILROAD MEDICARE
AL
Enumeration date
06/09/2006
Last updated
07/30/2008
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