Provider Demographics
NPI:1730134057
Name:JEFIC, DIJANA (MD)
Entity Type:Individual
Prefix:
First Name:DIJANA
Middle Name:
Last Name:JEFIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:861 CORONADO CENTER DR
Mailing Address - Street 2:STE 211
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3992
Mailing Address - Country:US
Mailing Address - Phone:702-818-9246
Mailing Address - Fax:702-492-1728
Practice Address - Street 1:229 N PECOS RD
Practice Address - Street 2:STE 120
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7364
Practice Address - Country:US
Practice Address - Phone:702-256-3637
Practice Address - Fax:702-256-3307
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV13545207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1730134057Medicaid
MII54095Medicare UPIN
NVV107393Medicare PIN
NV1730134057Medicaid
MI0P56330Medicare PIN