MEDICARE: DR. NANCY A HURCHIK-MUNACO MD

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	207Q00000X	Family Medicine Physician	NH045873	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080028849	OTHER	MI	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	102846	OTHER		CARE CHOICES PREFERRED CH
3	C3261	OTHER		MCARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	700F311630	OTHER	MI	BCBS GROUP

General Provider Information

NPI Number	:	1629047444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY A HURCHIK-MUNACO MD

Provider Business Mailing Address
First Line	:	23800 ORCHARD LAKE ROAD
Second Line	:	SUITE 100
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2561
Country	:	US
Telephone Number	:	248-476-2420
Fax Number	:	248-476-9709

Provider Business Practice Location Address
First Line	:	23800 ORCHARD LAKE ROAD
Second Line	:	SUITE 100
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2561
Country	:	US
Telephone Number	:	248-476-2420
Fax Number	:	248-476-9709

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

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	03/16/2021

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Directions to “ DR. NANCY A HURCHIK-MUNACO MD” Practice Location

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