Provider Demographics
NPI:1871670844
Name:ZOTOVIC, DANIJELA S (MD - INT MED & OPTHA)
Entity Type:Individual
Prefix:DR
First Name:DANIJELA
Middle Name:S
Last Name:ZOTOVIC
Suffix:
Gender:F
Credentials:MD - INT MED & OPTHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29802-0215
Mailing Address - Country:US
Mailing Address - Phone:803-648-7888
Mailing Address - Fax:803-648-3302
Practice Address - Street 1:410 UNIVERSITY PKWY
Practice Address - Street 2:AIKEN INTERNAL MED PA STE 2500
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6810
Practice Address - Country:US
Practice Address - Phone:803-648-7888
Practice Address - Fax:803-648-3302
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20884207R00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC110188630OtherRAILROAD MEDICARE
SC208849Medicaid
SC208849Medicaid
G969263498Medicare ID - Type Unspecified