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Michael Stack Md Pc
Family Nurse Practitioner in Ithaca, Michigan
NPI 1376580175

Michael Stack Md Pc is a Family Nurse Practitioner based in Ithaca, MI and is specialized in Family. Michael Stack Md Pc practices in Ithaca, MI. The NPI Number for Michael Stack Md Pc is 1376580175 and holds a License No. (Michigan).

The current practice location address for Michael Stack Md Pc is 121 N Pine River St, Ithaca, MI and can be reached out via phone at 989-875-5111 and via fax at 989-875-5023.

Location: 121 N Pine River St, Ithaca, MI, 48847-1039
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1376580175
Provider Name
Michael Stack Md Pc
Credential
Provider Entity Type
Organization
Address
121 N Pine River St, Ithaca, MI, 48847-1039
Phone Number
989-875-5111
Fax Number
989-875-5023
Provider Enumeration Date
06/01/2006
Last Update Date
02/15/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
0B91071 01 MI BCBSM
institution
Provider Business Practice Location Address Details
Address
121 N Pine River St
City
Ithaca
State
Michigan
Zip
48847-1039
Phone Number
989-875-5111
Fax Number
989-875-5023
person
Provider Business Mailing Address Details
Address
121 N Pine River St
City
Ithaca
State
Michigan
Zip
48847-1039
Phone Number
989-875-5111
Fax Number
989-875-5023
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
(Michigan)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rural Health
Taxonomy
261QR1300X
License No.
4301064712 (Michigan)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
(Michigan)
Definition
Definition to come...
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