Provider Demographics
NPI:1124805601
Name:STOJIC, SRDJAN
Entity type:Individual
Prefix:
First Name:SRDJAN
Middle Name:
Last Name:STOJIC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 HIALEAH DR
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-6206
Mailing Address - Country:US
Mailing Address - Phone:440-263-0924
Mailing Address - Fax:
Practice Address - Street 1:14070 CEDAR RD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-3216
Practice Address - Country:US
Practice Address - Phone:440-263-0924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03443623183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist