Healthcare Provider Details

I. General information

NPI: 1376029769
Provider Name (Legal Business Name): NEBOJSA MARKOVIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 FAIRMONT BLVD
RAPID CITY SD
57701-7375
US

IV. Provider business mailing address

353 FAIRMONT BLVD
RAPID CITY SD
57701-7375
US

V. Phone/Fax

Practice location:
  • Phone: 973-932-9475
  • Fax:
Mailing address:
  • Phone: 973-932-9475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number18001
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: