MEDICARE: SYDNEY DUBKE AGACNP

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	363L00000X	Nurse Practitioner	4704354949	MI

General Provider Information

NPI Number	:	1053260315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY DUBKE AGACNP

Provider Business Mailing Address
First Line	:	865 READY RD
Second Line	:
City	:	CARLETON
State	:	MI
Zip	:	48117-9769
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5315 ELLIOTT DR
Second Line	:
City	:	YPSILANTI
State	:	MI
Zip	:	48197-8634
Country	:	US
Telephone Number	:	734-712-0655
Fax Number	:

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

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/30/2026

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