Individual
OKTAVIJAN MIKLEUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
33014 5 MILE RD, LIVONIA, MI 48154-3075
(734) 261-7401
(734) 261-7410
Mailing address
20952 E 12 MILE RD, SUITE 200, SAINT CLAIR SHORES, MI 48081-3200
(586) 771-4820
(586) 771-6620
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704237979
MI
Other
Enumeration date
02/07/2007
Last updated
10/03/2019
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