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NPI Code Detail

MEDICARE: DR. SRDJAN MIRKOVIC MD

MEDICARE: DR. SRDJAN MIRKOVIC MD
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
1207XS0117XOrthopaedic Surgery of the Spine Physician036082410IL

General Provider Information

NPI Number : 1649243007
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SRDJAN MIRKOVIC MD
Provider Business Mailing Address
First Line : 680 N LAKE SHORE DR
Second Line : SUITE 924
City : CHICAGO
State : IL
Zip : 60611-4546
Country : US
Telephone Number : 312-664-6848
Fax Number :
Provider Business Practice Location Address
First Line : 1330 BOILING SPRINGS RD STE 1600
Second Line :
City : SPARTANBURG
State : SC
Zip : 29303-4219
Country : US
Telephone Number : 864-582-6396
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 03/03/2025

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