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General NPI Number Information
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NPI Number | 1841222080
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Entity Type | Individual
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Provider Name | DANIEL BIELAK D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 11/15/2011
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Provider Practice Location Address
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Address Line | 5900 WALDON RD
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City | CLARKSTON
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State | MI
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Zip | 48346-4806
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Country | US
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Telephone | 248-625-1058
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Fax | 248-625-3670
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Provider Business Mailing Address
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Address Line | 5900 WALDON RD
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City | CLARKSTON
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State | MI
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Zip | 48346-4806
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Country | US
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Telephone | 248-625-1058
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Fax | 248-625-3670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101006604
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License Number State | MI
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