Healthcare Provider Details

I. General information

NPI: 1831586866
Provider Name (Legal Business Name): MICHAEL ALEXANDER STOJANOVIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 S 144TH ST STE 212
OMAHA NE
68144-5253
US

IV. Provider business mailing address

2725 S 144TH ST STE 212
OMAHA NE
68144-5253
US

V. Phone/Fax

Practice location:
  • Phone: 402-609-3000
  • Fax: 402-609-3808
Mailing address:
  • Phone: 402-609-3000
  • Fax: 402-609-3808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036155465
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD-50230
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number036155465
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberMD-50230
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number34890
License Number StateNE
# 6
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number34890
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: