Doctor Name: | IRENE S DANEK |
NPI Number: | 1184841579 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 4301028968 |
Business Practice Address: | 9900 Diamond Park Rd Interlochen, MI - 496439339 |
Business Phone Number: | 2312767220 |
Business Fax Number: | 2312767881 |
Mailing Address: | 6438 Mission Rdg, TRAVERSE CITY |
State: | MI |
Postal Code: | 496866121 |
Phone Number: | 2319460224 |
Fax Number: | 2312767881 |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4301028968 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |