Active NPI
Stefan Markovic, MD
- Family Medicine Physician
- Philadelphia, PA
National Provider Identifier
1700448511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MT218905
- Practice address
- 10 Shurs LN
#203
Philadelphia, PA 19127 - Phone
- (215) 482-1234
- NPI assigned
- Jul 1, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MT218905 | PA | Primary |
Addresses
Primary practice location
10 Shurs LN
#203
Philadelphia, PA 19127
Mailing address
6 Grasspoint Cres
Etobicoke, ON M9C 2V1
CA
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT218905 | PA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656374400000",
"number": "1700448511",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "6 GRASSPOINT CRES",
"city": "ETOBICOKE",
"state": "ON",
"postal_code": "M9C 2V1"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 SHURS LN",
"address_2": "#203",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19127",
"telephone_number": "215-482-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKOVIC",
"first_name": "STEFAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-01",
"last_updated": "2022-06-28",
"certification_date": "2022-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MT218905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.