Provider Demographics
NPI:1528514833
Name:JURJEVIC, STEFAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEFAN
Middle Name:
Last Name:JURJEVIC
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 S CRAWFORD ST
Mailing Address - Street 2:APT F7
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-6143
Mailing Address - Country:US
Mailing Address - Phone:207-745-5854
Mailing Address - Fax:
Practice Address - Street 1:146 N CORNING ST
Practice Address - Street 2:
Practice Address - City:FARWELL
Practice Address - State:MI
Practice Address - Zip Code:48622-9737
Practice Address - Country:US
Practice Address - Phone:989-588-2599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-27
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302044518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist