Provider Demographics
NPI:1659450559
Name:STIKOVAC, DAISY MARGARET (MD)
Entity Type:Individual
Prefix:DR
First Name:DAISY
Middle Name:MARGARET
Last Name:STIKOVAC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11340 HEDGEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-7594
Mailing Address - Country:US
Mailing Address - Phone:502-533-7603
Mailing Address - Fax:502-228-4264
Practice Address - Street 1:3615 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1842
Practice Address - Country:US
Practice Address - Phone:702-508-9461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY363292084P0800X
NV214432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H68461Medicare UPIN