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General NPI Number Information
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NPI Number | 1033883269
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Entity Type | Organization
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Legal Business Name | MARTIN S DUBRAVEC MD, PC
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 200 E MASON ST
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City | CADILLAC
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State | MI
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Zip | 49601-1988
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Country | US
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Telephone | 231-779-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E MASON ST
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City | CADILLAC
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State | MI
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Zip | 49601-1988
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Country | US
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Telephone | 231-779-4444
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Fax |
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Authorized Official
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Title or Position | CEO PHYSICIAN HEALTH CARE PROVIDER
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Name | MARTIN DUBRAVEC
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Credential |
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Telephone | 231-779-4444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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