Healthcare Provider Details

I. General information

NPI: 1467463570
Provider Name (Legal Business Name): VLADIMIR DJURIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6651 FRANK AVE NW
NORTH CANTON OH
44720-7259
US

IV. Provider business mailing address

PO BOX 26125
AKRON OH
44319-6125
US

V. Phone/Fax

Practice location:
  • Phone: 330-498-9865
  • Fax:
Mailing address:
  • Phone: 330-493-0840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35062774
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: