Individual
ALEXANDER IVASKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 232-7132
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-1111
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2009004340
MO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
50007
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35222300
—
WI
05
—
547478000
—
MN
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
06/05/2007
Last updated
07/23/2024
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