Marty Phillip Dack is a Family in Lansing, Michigan. Marty Phillip Dack practices all healthcare services and medical treatments related to Family. The NPI Number for Marty Phillip Dack is 1871686337. The last update date is 2010-08-26.
Marty Phillip Dack's current location address is 1703 E Michigan Ave, Lansing, Michigan. You can contact this provider via phone number 5179133860 and fax number 5174846864. The mailing address for Marty Phillip Dack is 1703 E Michigan Ave, Lansing, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Marty Phillip Dack |
|---|---|
| Address | 1703 E Michigan Ave, Lansing, Michigan |
| Phone Number | 5179133860 |
| Fax Number | 5174846864 |
| Sole Proprietor | N |
| Credentials | NP |
NPI Number Detail
| NPI Number | 1871686337 |
|---|---|
| Provider Enumeration Date | 2006-10-02 |
| Last Updated Date | 2010-08-26 |
Provider Mailing Address Detail
| Address | 1703 E Michigan Ave |
|---|---|
| City | Lansing |
| State | Michigan (MI) |
| Post Code | 489122841 |
| Phone Number | 5179133860 |
| Fax Number | 5174846864 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 4704222015 |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1057822 | MI | MCLAREN HEALTH PLAN-COMMERCIAL | |
| 200000006547 | MI | PHP FAMILYCARE | |
| 4950304 | MI | -- | |
| 5008702500 | MI | BLUE CROSS BLUE SHILED | |
| P00367059 | MI | RAILROAD MEDICARE | |
| 1057822 | MI | MCLAREN HEALTH ADVANTAGE | |
| 1057822 | MI | MCLAREN HEALTH PLAN-MEDICAID | |
| 7952506 | MI | AETNA | |
| N55170013 | MI | MEDICARE PLUS BLUE | |
| 200000006547 | MI | PHP |
Post Comment/ Review Below
Could you provide the complete physical address where Marty Phillip Dack is located?
The Marty Phillip Dack is situated at the following address: 1703 E Michigan Ave, Lansing, MI, 489122841.
Could you kindly provide the complete physical address where Marty Phillip Dack's facilities are geographically located?
The facilities of Marty Phillip Dack are physically situated at the following location: 1703 E Michigan Ave, Lansing, MI, 489122841.
On what date did Marty Phillip Dack receive its 1871686337 assignment from the Centers for Medicare & Medicaid Services?
The Marty Phillip Dack was assigned its 1871686337 on 2006-10-02, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
On what date did the Centers for Medicare & Medicaid Services assign the 1871686337 to Marty Phillip Dack?
The Centers for Medicare & Medicaid Services assigned the 1871686337 to Marty Phillip Dack on 2006-10-02.
When was the information related to Marty Phillip Dack most recently updated or refreshed?
The details pertaining to the Marty Phillip Dack, including its address, specialty, and other relevant information, were last updated or refreshed on 2010-08-26.