Provider Demographics
NPI:1770646648
Name:BUGARIJA, NENAD (MD)
Entity type:Individual
Prefix:
First Name:NENAD
Middle Name:
Last Name:BUGARIJA
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 1:300 NORTHPOINTE CIR STE 302
Mailing Address - Street 2:
Mailing Address - City:SEVEN FIELDS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-7862
Mailing Address - Country:US
Mailing Address - Phone:724-776-5570
Mailing Address - Fax:724-776-5575
Practice Address - Street 1:300 NORTHPOINTE CIR STE 302
Practice Address - Street 2:
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-7862
Practice Address - Country:US
Practice Address - Phone:724-776-5570
Practice Address - Fax:724-776-5575
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419610207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001914897Medicaid
PAH67636Medicare UPIN
PA001914897Medicaid