Individual
MIO M STIKOVAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191
(702) 653-3257
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191
(702) 653-3257
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01049387A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
30015
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000052136
ANTHEM BCBS
KY
01
—
000000867525
ANTHEM-CTS
KY
01
—
060052920
RAILROAD MEDICARE TVILLE
—
01
—
060052923
RAILROAD MEDICARE
KY
01
—
060057636
RAILROAD MEDICARE/MADISON
IN
01
—
1079152
PASSPORT HEALTH PLAN
—
01
—
1169908
CHA PROVIDER NETWORK
—
01
—
159683
SIHO-CTS
KY
05
—
200059360
—
IN
01
—
25-00439
UNITED HEALTHCARE
KY
01
—
2552053001
CIGNA
—
01
—
299856
FEDERAL BLACK LUNG PROGRA
—
01
—
3121962
BCBS TENNESSEE
—
01
—
415633P
SIHO
IN
01
—
50065353
PASSPORT-CTS
KY
01
—
6113371060A11
ANTHEM SR. ADVANTAGE
—
05
—
64300155
—
KY
01
—
835778
FIRST HEALTH
—
01
—
P01333108
MEDICARE RR-CTS
KY
Enumeration date
10/27/2006
Last updated
07/16/2018
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