Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 039614 | CT |
NPI | 1053382416 |
---|---|
Provider Name | Dr. Goran Miljkovic |
First Address | Stratford, CT 06614-4850 |
Second Address | Stratford, CT 06614-4850 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 05/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001396143 | (05) | CT |
001396143 | CHN (01) | CT |
001396143 | FIRST CHOICE (01) | CT |
001396143-00 | BLUECARE FAMILY PLAN (01) | CT |
010039614CT03 | BLUE CROSS (01) | CT |
061608343 | UNITED HEALTHCARE (01) | CT |
069614 | CT CARE (01) | CT |
110243501 | RAILROAD MEDICARE (01) | CT |
198599/241469 | WELLCARE (01) | CT |
2807118/2843349 | AETNA (01) | CT |
2V0848 | HEALTHNET (01) | CT |
H43429 | (02) | CT |
P2522396 | OXFORD (01) | CT |