Individual
KSENIJA B STEFANOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD00040322
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039595
LABOR AND INDUSTRIES #
WA
01
—
110227486
RAILROAD MC#
WA
01
—
7561ST
BLUE SHIELD #
WA
05
—
8290728
—
WA
05
—
MD4260W
—
AK
01
—
US2606025
AETNA SPECIALIST PIN
WA
Enumeration date
10/11/2006
Last updated
03/12/2015
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