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NPI Code Detail

MEDICARE: VEDRANA MIKIC OD

MEDICARE:   VEDRANA  MIKIC  OD
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
1152W00000XOptometristOPT.007038OH

General Provider Information

NPI Number : 1477291821
Entity Type Code : Individual
Provider Name (Legal Business Name) : VEDRANA MIKIC OD
Provider Business Mailing Address
First Line : 7625 HARVEST LN
Second Line :
City : SEVEN HILLS
State : OH
Zip : 44131-5749
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3497 STEELYARD DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-2385
Country : US
Telephone Number : 216-706-1518
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2022
Last Update Date : 05/25/2022

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Directions to “ VEDRANA MIKIC OD” Practice Location

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