Provider Demographics
NPI:1891700688
Name:TOSIC, ALEKSANDAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEKSANDAR
Middle Name:
Last Name:TOSIC
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 1:19798 GOLFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-9465
Mailing Address - Country:US
Mailing Address - Phone:231-796-6253
Mailing Address - Fax:
Practice Address - Street 1:650 LINDEN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-1879
Practice Address - Country:US
Practice Address - Phone:231-796-6721
Practice Address - Fax:231-796-1080
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075203207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301075203OtherPHYSICIAN LICENSE
MI4134129Medicaid
MIOM94510001Medicare ID - Type Unspecified
MI4134129Medicaid