Provider Demographics
NPI:1033603139
Name:KADRIBEGIC, AJLA (MD)
Entity type:Individual
Prefix:
First Name:AJLA
Middle Name:
Last Name:KADRIBEGIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 OAK LAWN AVE UNIT 192749
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4688
Mailing Address - Country:US
Mailing Address - Phone:510-683-9500
Mailing Address - Fax:877-880-2039
Practice Address - Street 1:2825 OAK LAWN AVE UNIT 192749
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4688
Practice Address - Country:US
Practice Address - Phone:510-683-9500
Practice Address - Fax:877-880-2039
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01094001A2085R0202X
ALMD488892085R0202X
HIMD242782085R0202X
NC2024-016672085R0202X
390200000X
IL0361720352085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program