Stana Nickolich, MD
Student in an Organized Health Care Education/Training Program in Canton, MI. Individual provider (NPI-1).
NPI number1104516004
StatusActive
Last updated in NPPESMay 12, 2023
Details
- NPI
- 1104516004
- Entity type
- Individual (NPI-1)
- Name
- Stana Nickolich
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 12, 2023
- Certification date
- May 12, 2023
- Last updated
- May 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | 4351050571 | MI | Yes |
Practice location
1051 N Canton Center RdCanton, MI 48187-5097
Phone 734-647-5670
Mailing address
1500 E Medical Center Dr Spc 5368Ann Arbor, MI 48109-5368
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All 68 Student in an Organized Health Care Education/Training Program providers in Canton · All 2,409 providers in Canton
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