Individual
MARIJAN KOPRIVANAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-6157
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-6157
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MT214543
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2013
Last updated
07/24/2019
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