Provider Demographics
NPI:1477533081
Name:VELIMIROVIC, BRATISLAV M (MD)
Entity Type:Individual
Prefix:
First Name:BRATISLAV
Middle Name:M
Last Name:VELIMIROVIC
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 1:1400 GEORGE DIETER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7654
Mailing Address - Country:US
Mailing Address - Phone:915-247-3150
Mailing Address - Fax:915-703-3745
Practice Address - Street 1:1400 GEORGE DIETER DR STE 100
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7654
Practice Address - Country:US
Practice Address - Phone:915-247-3150
Practice Address - Fax:915-703-3745
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036113344207T00000X
TXP40002084V0102X, 2085R0204X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0C97618OtherBCBSM
MI0C97618OtherBCBSM