Provider Demographics
NPI:1245309384
Name:SVETIC, ANTONELA (MD)
Entity type:Individual
Prefix:
First Name:ANTONELA
Middle Name:
Last Name:SVETIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3572 DAYTON XENIA RD STE 217
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45432-2838
Mailing Address - Country:US
Mailing Address - Phone:937-433-0085
Mailing Address - Fax:937-433-0084
Practice Address - Street 1:3572 DAYTON XENIA RD STE 217
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45432-2838
Practice Address - Country:US
Practice Address - Phone:937-433-0085
Practice Address - Fax:937-433-0084
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350740142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2525986Medicaid
OH000000349560OtherANTHEM
OH000000349560OtherANTHEM
OH2525986Medicaid
OH4147813Medicare PIN