| Michael Stack Md Pc | |
|
121 N Pine River St Ithaca MI 48847-1039 | |
| (989) 875-5111 | |
| (989) 875-5023 |
| Full Name | Michael Stack Md Pc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 121 N Pine River St, Ithaca, Michigan |
| Authorized Official Name and Position | Michael Andrew Stack (OWNER) |
| Authorized Official Contact | 9898755111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Stack Md Pc 121 N Pine River St Ithaca MI 48847-1039 Ph: (989) 875-5111 | Michael Stack Md Pc 121 N Pine River St Ithaca MI 48847-1039 Ph: (989) 875-5111 |
| NPI Number | 1376580175 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 01/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376580175 | NPI | - | NPPES |
| 0B91071 | Other | MI | BCBSM |
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