Provider Demographics
NPI:1245612233
Name:ALEKSANDAR ROSICH MD INC
Entity type:Organization
Organization Name:ALEKSANDAR ROSICH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEKSANDAR
Authorized Official - Middle Name:V
Authorized Official - Last Name:ROSICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-366-2575
Mailing Address - Street 1:PO BOX 806
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-0806
Mailing Address - Country:US
Mailing Address - Phone:414-507-4741
Mailing Address - Fax:866-571-3491
Practice Address - Street 1:18740 W BLUEMOUND RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-2936
Practice Address - Country:US
Practice Address - Phone:920-366-2575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43071207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34064700Medicaid