Provider Demographics
NPI:1417090267
Name:TODOROVIC, SLOBODAN M (MD)
Entity Type:Individual
Prefix:
First Name:SLOBODAN
Middle Name:M
Last Name:TODOROVIC
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:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UVA HOSPITAL
Practice Address - Street 2:LEE STREET, 2ND FLOOR
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0001
Practice Address - Country:US
Practice Address - Phone:434-982-4310
Practice Address - Fax:434-982-0019
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231507207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005706661Medicaid
VA050001663Medicare PIN
VAH15949Medicare UPIN