Provider Demographics
NPI:1184677577
Name:STIPINOVICH, VANESSA MARINA (MD,)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:MARINA
Last Name:STIPINOVICH
Suffix:
Gender:F
Credentials:MD,
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4045 E BELL RD
Mailing Address - Street 2:STE #143
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2236
Mailing Address - Country:US
Mailing Address - Phone:602-867-0404
Mailing Address - Fax:602-788-0893
Practice Address - Street 1:4045 E BELL RD
Practice Address - Street 2:STE #143
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2236
Practice Address - Country:US
Practice Address - Phone:602-867-0404
Practice Address - Fax:602-788-0893
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ335982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology