Provider Demographics
NPI:1730063264
Name:PAVICEVIC, ZORAN
Entity type:Individual
Prefix:
First Name:ZORAN
Middle Name:
Last Name:PAVICEVIC
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 1:1315 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1132
Mailing Address - Country:US
Mailing Address - Phone:334-262-1113
Mailing Address - Fax:877-836-7673
Practice Address - Street 1:1315 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1132
Practice Address - Country:US
Practice Address - Phone:334-262-1113
Practice Address - Fax:877-836-7673
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18918290732084N0400X
ALF102410802084E0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty