MEDICARE: DR. ALEKSANDAR CVETKOVIC M.D.

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	207Q00000X	Family Medicine Physician	4301068171	MI

General Provider Information

NPI Number	:	1851382196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEKSANDAR CVETKOVIC M.D.

Provider Business Mailing Address
First Line	:	2888 E. LONG LAKE RD.
Second Line	:	SUITE 105
City	:	TROY
State	:	MI
Zip	:	48085-3700
Country	:	US
Telephone Number	:	248-689-1330
Fax Number	:	248-689-6424

Provider Business Practice Location Address
First Line	:	2888 E. LONG LAKE RD.
Second Line	:	SUITE 105
City	:	TROY
State	:	MI
Zip	:	48085-3700
Country	:	US
Telephone Number	:	248-689-1330
Fax Number	:	248-689-6424

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

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	05/16/2012

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