Healthcare Provider Details

I. General information

NPI: 1033320551
Provider Name (Legal Business Name): LJUBISA M. STANKOVIC, M.D., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

797 POPLAR CHURCH RD
CAMP HILL PA
17011-2314
US

IV. Provider business mailing address

797 POPLAR CHURCH RD
CAMP HILL PA
17011-2314
US

V. Phone/Fax

Practice location:
  • Phone: 717-763-4383
  • Fax: 717-763-4953
Mailing address:
  • Phone: 717-763-4383
  • Fax: 717-763-4953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD037459L
License Number StatePA

VIII. Authorized Official

Name: DR. LJUBISA MIHAJLO STANKOVIC
Title or Position: PRESIDENT
Credential: M.D.
Phone: 717-763-4383