Provider Demographics
NPI:1659361806
Name:STECEVIC, VESLAV (MD)
Entity Type:Individual
Prefix:MR
First Name:VESLAV
Middle Name:
Last Name:STECEVIC
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:PO BOX 13906
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4030
Mailing Address - Country:US
Mailing Address - Phone:248-625-4055
Mailing Address - Fax:248-625-4085
Practice Address - Street 1:5701 BOW POINTE DRIVE
Practice Address - Street 2:SUITE 370
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346
Practice Address - Country:US
Practice Address - Phone:248-625-4055
Practice Address - Fax:248-625-4085
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023050619207RG0100X
MI4301069946207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI447436310Medicaid
H78445Medicare UPIN
MIP32350001Medicare PIN