Individual
VJEKOSLAV MIKELIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-3248
(586) 741-4604
Mailing address
51307 GRATIOT AVE, CHESTERFIELD, MI 48051-2079
(586) 741-3772
(586) 741-4604
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301034048
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H26188
BCBS PROVIDER NUMBER
MI
01
—
0H26188002
FED BLACK LUNG PROGRAM
—
01
—
0Q26008
BCBS PROVIDER NUMBER
MI
01
—
0Q26008002
FED BLACK LUNG PROGRAM
—
01
—
1006439
MCLAREN HEALTH
MI
01
—
117547
GREAT LAKES HEALTH
MI
05
—
1366587
—
MI
01
—
136658710
PROCARE
MI
01
—
300008865
RR MEDICARE/PALMETTO GBA
—
Enumeration date
01/16/2006
Last updated
09/19/2025
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