Provider Demographics
NPI:1851382196
Name:CVETKOVIC, ALEKSANDAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEKSANDAR
Middle Name:
Last Name:CVETKOVIC
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 1:2888 E. LONG LAKE RD.
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3700
Mailing Address - Country:US
Mailing Address - Phone:248-689-1330
Mailing Address - Fax:248-689-6424
Practice Address - Street 1:2888 E. LONG LAKE RD.
Practice Address - Street 2:SUITE 105
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-3700
Practice Address - Country:US
Practice Address - Phone:248-689-1330
Practice Address - Fax:248-689-6424
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301068171207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OM82170Medicare PIN
G94572Medicare UPIN
0M82170001Medicare ID - Type Unspecified