Provider Demographics
NPI:1356481949
Name:MILOSAVLJEVIC, STACI LYNNE (MD)
Entity Type:Individual
Prefix:DR
First Name:STACI
Middle Name:LYNNE
Last Name:MILOSAVLJEVIC
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DIVISION OF CARDIOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-955-6777
Mailing Address - Fax:414-955-6203
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DIVISION OF CARDIOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-955-6777
Practice Address - Fax:414-955-6203
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2013-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI47521-020207R00000X
WI47521207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1356481949Medicaid
WI1356481949Medicaid
WI68086 1091Medicare PIN