Healthcare Provider Details

I. General information

NPI: 1538100193
Provider Name (Legal Business Name): JADRANKA POPOVIC M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 10/01/2020
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1789 S BRADDOCK AVE SUITE 294
PITTSBURGH PA
15218-1842
US

IV. Provider business mailing address

1789 S BRADDOCK AVE SUITE 294
PITTSBURGH PA
15218-1842
US

V. Phone/Fax

Practice location:
  • Phone: 412-371-3000
  • Fax: 412-371-8128
Mailing address:
  • Phone: 412-371-3000
  • Fax: 412-371-8128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number04-29327
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number2001032802
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberMD434381
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: