Healthcare Provider Details

I. General information

NPI: 1588897169
Provider Name (Legal Business Name): ZORAN B POPOVIC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2009
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE J1-5
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE J1-5
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-6003
  • Fax: 216-445-6150
Mailing address:
  • Phone: 216-445-6003
  • Fax: 216-445-6150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.09433
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.095433
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: