Provider Demographics
NPI:1578567145
Name:ZUBIC, SNEZANA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SNEZANA
Middle Name:M
Last Name:ZUBIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SNEZANA
Other - Middle Name:MITAR
Other - Last Name:NOVOKMET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3800 SAINT MARY RD
Mailing Address - Street 2:STE 103
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3986
Mailing Address - Country:US
Mailing Address - Phone:219-464-2123
Mailing Address - Fax:219-464-0032
Practice Address - Street 1:3800 SAINT MARY RD
Practice Address - Street 2:STE 103
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3986
Practice Address - Country:US
Practice Address - Phone:219-464-2123
Practice Address - Fax:219-464-0032
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01049443A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200180100AMedicaid
IN200180100AMedicaid
ING88060Medicare UPIN
IN090450BMedicare PIN