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General NPI Number Information
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NPI Number | 1629158167
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Entity Type | Organization
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Legal Business Name | JURE GRAHOVAC, M.D., P.C.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18181 OAKWOOD BLVD
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City | DEARBORN
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State | MI
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Zip | 48124-5032
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Country | US
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Telephone | 313-271-0640
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Fax |
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Provider Business Mailing Address
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Address Line | 18181 OAKWOOD BLVD STE 203
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City | DEARBORN
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State | MI
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Zip | 48124-4082
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Country | US
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Telephone | 313-271-0640
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JURE GRAHOVAC
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Credential | MD
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Telephone | 313-271-0640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301035488
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License Number State | MI
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