Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01055293A | IN |
N | 111NI0900X | Internist | 01055293A | IN |
Y | 207RG0300X | Geriatric Medicine | 35-090432 | OH |
NPI | 1053396168 |
---|---|
Provider Name | Gordana Gataric |
First Address | Dayton, OH 45435-0001 |
Second Address | Dayton, OH 45435-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2005 |
Last Update Date | 02/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200383790A | (05) | IN |
2804451 | (05) | OH |
GA4220091 | (02) | OH |
H78311 | (02) | IN |