Healthcare Provider Details

I. General information

NPI: 1508182346
Provider Name (Legal Business Name): PAVLE DOROSLOVACKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 LOCUST ST
PITTSBURGH PA
15219-5924
US

IV. Provider business mailing address

1622 LOCUST ST # 5.320B
PITTSBURGH PA
15219-5924
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-2200
  • Fax: 724-786-7690
Mailing address:
  • Phone: 412-642-5381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License NumberMD447548
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD447548
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: