MEDICARE: SANJA NOVAKOVIC

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	172V00000X	Community Health Worker		MI

General Provider Information

NPI Number	:	1982303350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANJA NOVAKOVIC

Provider Business Mailing Address
First Line	:	PO BOX 4274
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48826-4274
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1140 ABBOTT RD UNIT 4274
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-2615
Country	:	US
Telephone Number	:	917-750-3226
Fax Number	:

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

Provider Enumeration Date	:	02/24/2023
Last Update Date	:	11/18/2025

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Directions to “ SANJA NOVAKOVIC ” Practice Location

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