Provider Demographics
NPI:1275207458
Name:BUZAKOVIC, ANDREA TIJANA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:TIJANA
Last Name:BUZAKOVIC
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 TARRY TOWN PL
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-7721
Mailing Address - Country:US
Mailing Address - Phone:701-527-5232
Mailing Address - Fax:
Practice Address - Street 1:3103 YORKTOWN DR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-8526
Practice Address - Country:US
Practice Address - Phone:701-425-0789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND6324183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist