Provider Demographics
NPI:1275779894
Name:RADEVIC, MIROSLAV RADE (MD)
Entity Type:Individual
Prefix:DR
First Name:MIROSLAV
Middle Name:RADE
Last Name:RADEVIC
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:246 INDUSTRIAL WAY WEST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724
Mailing Address - Country:US
Mailing Address - Phone:732-389-5200
Mailing Address - Fax:732-389-5299
Practice Address - Street 1:246 INDUSTRIAL WAY W
Practice Address - Street 2:SUITE 2
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-4240
Practice Address - Country:US
Practice Address - Phone:732-389-5200
Practice Address - Fax:732-389-5299
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-02
Last Update Date:2016-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08496100207ZP0102X
NY257993207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology