Provider Demographics
NPI:1639388234
Name:STEFANEC, MILAN JULIAN (MD)
Entity Type:Individual
Prefix:
First Name:MILAN
Middle Name:JULIAN
Last Name:STEFANEC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8119 S LAKE STEVENS RD
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98205-2825
Mailing Address - Country:US
Mailing Address - Phone:425-397-0652
Mailing Address - Fax:425-397-0652
Practice Address - Street 1:8119 S LAKE STEVENS RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98205-2825
Practice Address - Country:US
Practice Address - Phone:425-397-0652
Practice Address - Fax:425-397-0652
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00034673207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAH01829Medicare UPIN
WA8803261Medicare ID - Type Unspecified