Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD021521E | PA |
Y | 208D00000X | General Practice Physician | MD021521E | PA |
NPI | 1013989581 |
---|---|
Provider Name | Dr. Nenad B Janicijevic |
First Address | Mt Lebanon, PA 15228-1643 |
Second Address | Mt Lebanon, PA 15228-1643 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 15/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0681487 | (05) | PA |
100674 | UPMC HEALTH PLAN (01) | PA |
1530211 | HIGHMARK OF PA (01) | PA |
210694500 | US DEPT OF DISABILITY (01) | PA |
228827401 | OXFORD (01) | PA |
700000896 | PALAMATO GBA RAILROAD MED (01) | PA |
B37385 | (02) | PA |
ME121910 | HIGHMARK OF PA (01) | PA |