Provider Demographics
NPI:1912494915
Name:ANTIC, MILICA (MD)
Entity type:Individual
Prefix:DR
First Name:MILICA
Middle Name:
Last Name:ANTIC
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 1:36001 GRAND RIVER AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3027
Mailing Address - Country:US
Mailing Address - Phone:513-250-9175
Mailing Address - Fax:
Practice Address - Street 1:29275 W 10 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2817
Practice Address - Country:US
Practice Address - Phone:248-350-2722
Practice Address - Fax:248-350-0154
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351048242207RC0200X, 207RS0012X, 207RP1001X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease