Provider Demographics
NPI:1932637568
Name:DUJMOVIC BASUROSKI, IRENA (MD)
Entity Type:Individual
Prefix:MRS
First Name:IRENA
Middle Name:
Last Name:DUJMOVIC BASUROSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:IRENA
Other - Middle Name:
Other - Last Name:DUJMOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:194 FINLEY GOLF COURSE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517
Mailing Address - Country:US
Mailing Address - Phone:984-974-2267
Mailing Address - Fax:919-966-2922
Practice Address - Street 1:194 FINLEY GOLF COURSE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517
Practice Address - Country:US
Practice Address - Phone:984-974-2267
Practice Address - Fax:919-966-2922
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-001312084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology