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General NPI Number Information
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NPI Number | 1528514833
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Entity Type | Individual
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Provider Name | STEFAN JURJEVIC PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 08/27/2016
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Last Update Date | 08/27/2016
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Provider Practice Location Address
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Address Line | 146 N CORNING ST
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City | FARWELL
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State | MI
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Zip | 48622-9737
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Country | US
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Telephone | 989-588-2599
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 S CRAWFORD ST APT F7
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858-6143
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Country | US
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Telephone | 207-745-5854
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302044518
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License Number State | MI
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