| Michael E. Stachecki, M.d., P.l.l.c. | |
|
5885 S Main St Suite 3 Clarkston MI 48346-2981 | |
| (248) 620-1720 | |
| (248) 620-1740 |
| Full Name | Michael E. Stachecki, M.d., P.l.l.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 5885 S Main St, Clarkston, Michigan |
| Authorized Official Name and Position | Michael E Stachecki (OWNER--MANAGING AGENT) |
| Authorized Official Contact | 2486201720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael E. Stachecki, M.d., P.l.l.c. 5885 S Main St Suite 3 Clarkston MI 48346-2981 Ph: (248) 620-1720 | Michael E. Stachecki, M.d., P.l.l.c. 5885 S Main St Suite 3 Clarkston MI 48346-2981 Ph: (248) 620-1720 |
| NPI Number | 1508992041 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 02/25/2014 |
| Medicare PECOS PAC ID | 8224133467 |
|---|---|
| Medicare Enrollment ID | O20070418000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508992041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301058225 (Michigan) | Primary |
| 208000000X | Pediatrics | 4301058225 (Michigan) | Secondary |
| Provider Name | Micheal E Stachecki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659345056 PECOS PAC ID: 3779688916 Enrollment ID: I20070418000043 |
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