MEDICARE: DOUGLAS MILOSAVLJEVIC, M.D., S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	32597	WI
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	32597	WI

General Provider Information

NPI Number	:	1558674028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOUGLAS MILOSAVLJEVIC, M.D., S.C.

Provider Business Mailing Address
First Line	:	225 S EXECUTIVE DR
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53005-4257
Country	:	US
Telephone Number	:	262-787-4026
Fax Number	:	262-782-6040

Provider Business Practice Location Address
First Line	:	8153 S 27TH ST
Second Line	:	SUITE 300
City	:	FRANKLIN
State	:	WI
Zip	:	53132-9549
Country	:	US
Telephone Number	:	414-761-1802
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DOUGLAS MILOSAVLJEVIC
Credential	:	M.D.
Telephone Number	:	262-787-4026

Provider Enumeration Date	:	07/26/2010
Last Update Date	:	07/26/2010

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