Provider Demographics
NPI:1912960501
Name:GVOZDEN, ANDRE BOJAN (MD)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:BOJAN
Last Name:GVOZDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:251 NAJOLES RD STE E
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-2519
Mailing Address - Country:US
Mailing Address - Phone:107-290-6904
Mailing Address - Fax:410-729-4057
Practice Address - Street 1:8601 VETERANS HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-1547
Practice Address - Country:US
Practice Address - Phone:410-729-0690
Practice Address - Fax:410-729-4057
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2024-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0026823208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB70723Medicare UPIN