Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 5151014121 | MI |
Y | 111NI0900X | Internist | 5151014121 | MI |
NPI | 1003477217 |
---|---|
Provider Name | Dr. Bojan Jokic |
First Address | Garden City, MI 48135-4001 |
Second Address | Garden City, MI 48135-4001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2019 |
Last Update Date | 27/06/2019 |