Provider Demographics
NPI:1801842976
Name:CVETKOVSKI, BORIS (MD)
Entity Type:Individual
Prefix:DR
First Name:BORIS
Middle Name:
Last Name:CVETKOVSKI
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 1:2011 FALLS VALLEY DR STE 106
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3452
Mailing Address - Country:US
Mailing Address - Phone:919-870-1311
Mailing Address - Fax:919-881-0822
Practice Address - Street 1:2011 FALLS VALLEY DR
Practice Address - Street 2:SUITE 106
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3452
Practice Address - Country:US
Practice Address - Phone:919-870-1311
Practice Address - Fax:919-881-0822
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500025207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2089911OtherCCN
NC5901202Medicaid
NC1380VOtherBLUE CROSS BLUE SHIELD
NC7138378OtherCIGNA
NCP00219685OtherRAILROAD MEDICARE
NC5593649OtherAETNA
NC1877717OtherUNITED HEALTHCARE
NC2089911OtherMAIL HANDLERS
NCD9864OtherMEDCOST
NCP00219685OtherRAILROAD MEDICARE
NC5901202Medicaid