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NPI Code Detail

MEDICARE: STONE MANCZAK FNP-BC

MEDICARE: STONE MANCZAK FNP-BC
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
1363LF0000XFamily Nurse Practitioner4704370249NSA240D7MI

General Provider Information

NPI Number : 1760223770
Entity Type Code : Individual
Provider Name (Legal Business Name) : STONE MANCZAK FNP-BC
Provider Business Mailing Address
First Line : 3040 E 7 MILE RD
Second Line :
City : DETROIT
State : MI
Zip : 48234-1662
Country : US
Telephone Number : 313-826-0179
Fax Number : 313-826-1092
Provider Business Practice Location Address
First Line : 3040 E 7 MILE RD
Second Line :
City : DETROIT
State : MI
Zip : 48234-1662
Country : US
Telephone Number : 313-826-0179
Fax Number : 313-826-1092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2024
Last Update Date : 04/28/2025

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Directions to “ STONE MANCZAK FNP-BC” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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