Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 2988 | OH |
NPI | 1255535472 |
---|---|
Provider Name | Dr. Dinko Hajdukovic |
First Address | Willoughby, OH 44094-7223 |
Second Address | Willoughby, OH 44094-7223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0532301 | (05) | OH |
U25002 | (02) | OH |