MEDICARE: DR. STANISLAW GOLEC M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	4301048694	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0829199	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1649572041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANISLAW GOLEC M.D.

Provider Business Mailing Address
First Line	:	32418 OLDE FRANKLIN DR
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-1740
Country	:	US
Telephone Number	:	248-855-5970
Fax Number	:

Provider Business Practice Location Address
First Line	:	32418 OLDE FRANKLIN DR
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-1740
Country	:	US
Telephone Number	:	248-855-5970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2010
Last Update Date	:	11/17/2010

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