Provider Demographics
NPI:1124046552
Name:ELVIRA DRLJEVIC MD PSC
Entity Type:Organization
Organization Name:ELVIRA DRLJEVIC MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ELVIRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DRLJEVIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-640-7031
Mailing Address - Street 1:3814 STONE RIVER CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-6543
Mailing Address - Country:US
Mailing Address - Phone:502-640-7031
Mailing Address - Fax:502-671-0380
Practice Address - Street 1:3814 STONE RIVER CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-6543
Practice Address - Country:US
Practice Address - Phone:502-640-7031
Practice Address - Fax:502-671-0380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY395642084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYI37752Medicare UPIN