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General NPI Number Information
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NPI Number | 1760503999
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Entity Type | Individual
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Provider Name | NENAD LILIC M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | ROYAL ALEXANDRA HOSPITAL 10240 KINGSWAY
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City | EDMONTON
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State | AB
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Zip | T5H3V9
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Country | CA
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Telephone | 780-735-4737
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Fax |
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Provider Business Mailing Address
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Address Line | 10411-105TH AVENUE APT. # 142
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City | EDMONTON
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State | AB
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Zip | T5H4R8
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Country | CA
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Telephone | 780-735-4737
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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 | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 223319
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License Number State | MA
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