Provider Demographics
NPI:1548468945
Name:STOJANOVICH, KOSTA (MD)
Entity type:Individual
Prefix:DR
First Name:KOSTA
Middle Name:
Last Name:STOJANOVICH
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 1:555 UNIVERSITY AVE APT 2303
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-5033
Mailing Address - Country:US
Mailing Address - Phone:808-941-4157
Mailing Address - Fax:
Practice Address - Street 1:555 UNIVERSITY AVE APT 2303
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-5033
Practice Address - Country:US
Practice Address - Phone:808-941-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD - 13492084P0800X, 2084F0202X
CAG - 100502084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry