Individual
DR. STJEPAN GARDILCIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
675 BALLY ROW, MANSFIELD, OH 44906
(419) 756-4999
(419) 756-4949
Mailing address
675 BALLY ROW, MANSFIELD, OH 44906
(419) 756-4999
(419) 756-4949
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35062560
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000198537
BLUE CROSS
OH
05
—
0849809
—
OH
Enumeration date
07/06/2006
Last updated
11/19/2009
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