Healthcare Provider Details

I. General information

NPI: 1831219708
Provider Name (Legal Business Name): AMILA ORUCEVIC M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 VIRGINIA WAY SUITE 300
BRENTWOOD TN
37027-7541
US

IV. Provider business mailing address

5301 VIRGINIA WAY SUITE 300
BRENTWOOD TN
37027-7541
US

V. Phone/Fax

Practice location:
  • Phone: 615-221-4474
  • Fax: 615-234-3774
Mailing address:
  • Phone: 615-221-4474
  • Fax: 615-234-3774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number036-104580
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number42408
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: