Provider Demographics
NPI:1306879093
Name:ZORIC, BOJAN BRIAN (MD)
Entity type:Individual
Prefix:
First Name:BOJAN
Middle Name:BRIAN
Last Name:ZORIC
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 1:1 ORTHOPEDICS DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960
Mailing Address - Country:US
Mailing Address - Phone:978-818-6350
Mailing Address - Fax:978-818-6355
Practice Address - Street 1:1 ORTHOPEDICS DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960
Practice Address - Country:US
Practice Address - Phone:978-818-6350
Practice Address - Fax:978-818-6355
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104620207XX0005X
MA227426207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC809859Medicare PIN