Provider Demographics
NPI:1801866330
Name:VELIMIROVICH, BORIS (MD,FACS)
Entity Type:Individual
Prefix:DR
First Name:BORIS
Middle Name:
Last Name:VELIMIROVICH
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 COLUMBIA DR
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-2391
Mailing Address - Country:US
Mailing Address - Phone:478-453-7516
Mailing Address - Fax:
Practice Address - Street 1:1217 COLUMBIA DR
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2391
Practice Address - Country:US
Practice Address - Phone:478-453-7516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA37453174400000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA334072OtherWELLCARE
GA637974OtherBCBS
GA00796265AMedicaid
GA637974OtherBCBS
34BDFDZMedicare PIN