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General NPI Number Information
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NPI Number | 1427964006
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Entity Type | Individual
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Provider Name | MITKO ANDREEVSKI RVT
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Gender | Male
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 22101 MOROSS RD
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City | DETROIT
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State | MI
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Zip | 48236-2148
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Country | US
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Telephone | 313-343-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 49262 BINGHAM LN
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City | MACOMB
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State | MI
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Zip | 48044-1549
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Country | US
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Telephone | 586-808-8827
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Fax |
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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 | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number | 196897
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License Number State | MI
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