Individual
NIKSA VLASIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 LAKESHORE DR, ISHPEMING, MI 49849-1367
(906) 486-4431
Mailing address
2837 US 41 W, MARQUETTE, MI 49855-2252
(906) 225-3964
(906) 226-3875
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
207073-1
NY
2085R0202X
Diagnostic Radiology Physician
Primary
4301073874
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02198052
—
NY
Enumeration date
03/08/2006
Last updated
09/18/2013
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