Provider Demographics
NPI:1053557199
Name:SAMARDZIJA, RADMILA (DPM)
Entity type:Individual
Prefix:DR
First Name:RADMILA
Middle Name:
Last Name:SAMARDZIJA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1050 S OUTER RD
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-3071
Mailing Address - Country:US
Mailing Address - Phone:816-228-9393
Mailing Address - Fax:816-228-5462
Practice Address - Street 1:8919 PARALLEL PKWY STE 550
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1545
Practice Address - Country:US
Practice Address - Phone:913-321-0522
Practice Address - Fax:913-334-9422
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL135000654213ES0103X
MO2011021447213ES0103X
KS1200383213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery