Provider Demographics
NPI:1326208406
Name:MILCEVIC, MARTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTINA
Middle Name:
Last Name:MILCEVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 219672
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64121-9672
Mailing Address - Country:US
Mailing Address - Phone:816-407-5430
Mailing Address - Fax:816-407-5435
Practice Address - Street 1:2521 GLENN HENDREN DR
Practice Address - Street 2:STE 306
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3388
Practice Address - Country:US
Practice Address - Phone:816-407-5430
Practice Address - Fax:816-407-5435
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014034705207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease