Provider Demographics
NPI:1346370137
Name:RADOJICIC, MILAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MILAN
Middle Name:
Last Name:RADOJICIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 W FLAMINGO RD # 6030
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2280
Mailing Address - Country:US
Mailing Address - Phone:408-205-8233
Mailing Address - Fax:408-205-8233
Practice Address - Street 1:650 5TH ST STE 405
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107
Practice Address - Country:US
Practice Address - Phone:408-205-8233
Practice Address - Fax:408-205-8233
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20260207Q00000X
AL43761207Q00000X
CAA89225207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1346370137Medicaid
AL43761OtherSTATE LICENSE
NV20260OtherSTATE LICENSE