Individual
IVANA NIKOLIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2000
Mailing address
170 W BROADWAY UNIT 301, BOSTON, MA 02127-1020
(336) 392-7742
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
243926
MA
207RC0000X
Cardiovascular Disease Physician
Primary
243926
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
243926
MA
Other
Enumeration date
12/21/2006
Last updated
03/07/2018
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