| Dr Miodrag Zivic Llc | |
|
25200 Chagrin Blvd Ste 300 Beachwood OH 44122-5684 | |
| (216) 383-2834 | |
| (216) 383-2923 |
| Full Name | Dr Miodrag Zivic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 25200 Chagrin Blvd Ste 300, Beachwood, Ohio |
| Authorized Official Name and Position | Miodrag V. Zivic (MD/OWNER) |
| Authorized Official Contact | 2163832834 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Miodrag Zivic Llc 25200 Chagrin Blvd Ste 300 Beachwood OH 44122-5684 Ph: (216) 383-2834 | Dr Miodrag Zivic Llc 25200 Chagrin Blvd Ste 300 Beachwood OH 44122-5684 Ph: (216) 383-2834 |
| NPI Number | 1437557782 |
|---|---|
| Provider Enumeration Date | 12/18/2014 |
| Last Update Date | 05/11/2022 |
| Medicare PECOS PAC ID | 9739405457 |
|---|---|
| Medicare Enrollment ID | O20150224000173 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437557782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Miodrag V Zivic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225011836 PECOS PAC ID: 6507807708 Enrollment ID: I20050518000609 |
| Provider Name | Michelle M Spech Holderbaum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851407167 PECOS PAC ID: 3577662139 Enrollment ID: I20070621000575 |
| Provider Name | Mary Jeewek Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306834940 PECOS PAC ID: 8729244256 Enrollment ID: I20120726000684 |
| Provider Name | Sandra W Lavelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457635229 PECOS PAC ID: 9032358924 Enrollment ID: I20130626000191 |
| Provider Name | Martin A Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235491275 PECOS PAC ID: 8022323443 Enrollment ID: I20150813012172 |
| Provider Name | Ronae J Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265953277 PECOS PAC ID: 4385915941 Enrollment ID: I20170801001826 |
| Provider Name | Jessica M Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932618642 PECOS PAC ID: 6406102698 Enrollment ID: I20180629002562 |
| Provider Name | Stephanie M West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598246902 PECOS PAC ID: 0749533479 Enrollment ID: I20181026001878 |
| Provider Name | Tina Van Kan-hunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114495702 PECOS PAC ID: 5193079408 Enrollment ID: I20181126000974 |
| Provider Name | Gurpreet Rastogi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326602517 PECOS PAC ID: 9133462880 Enrollment ID: I20190520002732 |
| Provider Name | Erin Leigh Sibben Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871109595 PECOS PAC ID: 4183034978 Enrollment ID: I20201105002885 |
| Provider Name | Ashish Rastogi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104493501 PECOS PAC ID: 5698176659 Enrollment ID: I20210628002711 |
| Provider Name | Kelli M Littlejohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194115048 PECOS PAC ID: 3971954074 Enrollment ID: I20240112000743 |
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