MEDICARE: DR. LJILJANA GRKOVICH 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
1	207L00000X	Anesthesiology Physician	52447	MA

General Provider Information

NPI Number	:	1659352748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LJILJANA GRKOVICH MD

Provider Business Mailing Address
First Line	:	PO BOX 9142
Second Line	:
City	:	CHARLESTOWN
State	:	MA
Zip	:	02129-9142
Country	:	US
Telephone Number	:	617-724-0287
Fax Number	:	617-726-2894

Provider Business Practice Location Address
First Line	:	230 HIGHLAND AVE
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02143-1408
Country	:	US
Telephone Number	:	617-666-4400
Fax Number	:	617-591-4460

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	10/24/2007

Similar Medicare Providers

1760481501 — DR. MICHAEL CLARENCE PAYNE M.D., M.P.H.
Practice Location Address:

230 HIGHLAND AVE , SOMERVILLE HOSPITAL / THE CAMBRIDGE HEALTH ALLIANCE
SOMERVILLE, MA
02143-1408

Practice Phone: 617-665-1000
Practice Fax:

1336111020 — DR. LOU ANN BRUNO-MURTHA D.O.
Practice Location Address:

230 HIGHLAND AVE
SOMERVILLE, MA
02143-1408

Practice Phone: 617-591-4780
Practice Fax: 617-591-4360

1760430755 — DR. MICHAEL HERCULES THEODOULOU D.P.M.
Practice Location Address:

230 HIGHLAND AVE
SOMERVILLE, MA
02143-1408

Practice Phone: 617-665-1000
Practice Fax:

1164476503 — INGO H STUBBE MD
Practice Location Address:

230 HIGHLAND AVE
SOMERVILLE, MA
02143-1408

Practice Phone: 617-591-4920
Practice Fax:

1417021437 — MANISH TANDON MD
Practice Location Address:

230 HIGHLAND AVE , MEDICAL SPECIALTIES
SOMERVILLE, MA
02143-1408

Practice Phone: 617-665-1552
Practice Fax:

1154498889 — RALPH H UPCHURCH MD
Practice Location Address:

230 HIGHLAND AVE
SOMERVILLE, MA
02143-1408

Practice Phone: 617-591-4707
Practice Fax:

Directions to “ DR. LJILJANA GRKOVICH MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.