Healthcare Provider Details

I. General information

NPI: 1770763070
Provider Name (Legal Business Name): MILENA DJURIC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CONIFER HILL DR STE 310
DANVERS MA
01923-1169
US

IV. Provider business mailing address

100 CONIFER HILL DR STE 310
DANVERS MA
01923-1169
US

V. Phone/Fax

Practice location:
  • Phone: 617-816-8747
  • Fax: 978-288-0144
Mailing address:
  • Phone: 617-816-8747
  • Fax: 978-288-0144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036-121760
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number234995
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: