Individual
DR. DESANKA STIPIC-PETROVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19900 E. 10 MILE ROAD, SUITE 102, ST. CLAIR SHORES, MI 48080-4412
(586) 776-3366
(586) 774-1808
Mailing address
19900 E. 10 MILE ROAD, SUITE 102, ST. CLAIR SHORES, MI 48080-4412
(586) 776-3366
(586) 774-1808
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
060579
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3018457 TYPE10
—
MI
Enumeration date
06/02/2005
Last updated
10/23/2019
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