MEDICARE: NATASA MIHIC M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	81940	AZ
2	208000000X	Pediatrics Physician	13615	NV

General Provider Information

NPI Number	:	1073710018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASA MIHIC M.D.

Provider Business Mailing Address
First Line	:	871 CORONADO CENTER DR STE 141
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3977
Country	:	US
Telephone Number	:	702-566-2400
Fax Number	:	702-433-2477

Provider Business Practice Location Address
First Line	:	871 CORONADO CENTER DR STE 141
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3977
Country	:	US
Telephone Number	:	702-566-2400
Fax Number	:	702-433-2477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	03/12/2020

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Directions to “ NATASA MIHIC M.D.” Practice Location

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