Individual provider · Type 1 NPI

Stana Nickolich, MD

Student in an Organized Health Care Education/Training Program · Canton, MI

NPI number 1104516004 Active

Practice location

1051 N Canton Center Rd
Canton, MI 48187-5097

Call (734) 647-5670 Map

Mailing address

1500 E Medical Center Dr Spc 5368
Ann Arbor, MI 48109-5368

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X4351050571 (MI)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1104516004

Stana Nickolich, MD's National Provider Identifier is 1104516004, issued on May 12, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Canton, MI. The record was last updated on May 12, 2023.