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General NPI Number Information
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NPI Number | 1134146905
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Entity Type | Individual
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Provider Name | ZDRAVKO SKRTIC MD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 200 JEFFERSON SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503
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Country | US
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Telephone | 616-364-6700
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Fax | 616-364-4960
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Provider Business Mailing Address
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Address Line | PO BOX 186
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City | GRAND RAPIDS
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State | MI
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Zip | 49501
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Country | US
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Telephone | 616-364-6700
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Fax | 616-364-4960
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301057728
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 4301057728
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License Number State | MI
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