Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301083615 | MI |
Y | 2080P0204X | Pediatric Emergency Doctor | 4301083615 | MI |
NPI | 1063459550 |
---|---|
Provider Name | Curt Stankovic |
First Address | Detroit, MI 48201 |
Second Address | Detroit, MI 48201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 13/11/2012 |