person
Mr. Marty Phillip Dack, NP
Family Nurse Practitioner in Lansing, Michigan
NPI 1871686337

Marty Phillip Dack is a Family Nurse Practitioner based in Lansing, MI and is specialized in Family. Marty Phillip Dack practices in Lansing, MI and has the professional credentials of NP. The NPI Number for Marty Phillip Dack is 1871686337 and holds a License No. 4704222015 (Michigan).

The current practice location address for Marty Phillip Dack is 1703 E Michigan Ave, Lansing, MI and can be reached out via phone at 517-913-3860 and via fax at 517-484-6864.

Location: 1703 E Michigan Ave, Lansing, MI, 48912-2841
person
Provider Profile Details
NPI Number
1871686337
Provider Name
Marty Phillip Dack
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
1703 E Michigan Ave, Lansing, MI, 48912-2841
Phone Number
517-913-3860
Fax Number
517-484-6864
Provider Enumeration Date
10/02/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1057822 01 MI MCLAREN HEALTH PLAN-COMMERCIAL
200000006547 01 MI PHP FAMILYCARE
4950304 05 MI
5008702500 01 MI BLUE CROSS BLUE SHILED
P00367059 01 MI RAILROAD MEDICARE
1057822 01 MI MCLAREN HEALTH ADVANTAGE
1057822 01 MI MCLAREN HEALTH PLAN-MEDICAID
7952506 01 MI AETNA
N55170013 01 MI MEDICARE PLUS BLUE
200000006547 01 MI PHP
institution
Provider Business Practice Location Address Details
Address
1703 E Michigan Ave
City
State
Zip
48912-2841
Phone Number
517-913-3860
Fax Number
517-484-6864
person
Provider Business Mailing Address Details
Address
1703 E Michigan Ave
City
State
Zip
48912-2841
Phone Number
517-913-3860
Fax Number
517-484-6864
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
4704222015 (Michigan)
Definition
Definition to come...
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