Individual
TERRENCE WAYNE TATARCHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8795 PINE RIDGE DR, SUITE B, CADILLAC, MI 49601-9777
(231) 775-1306
(231) 775-9701
Mailing address
8795 PINE RIDGE DR, SUITE B, CADILLAC, MI 49601-9777
(231) 775-1306
(231) 775-9701
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301039879
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01279
PRIORITY HEALTH
MI
01
—
0208309261
BLUE CROSS BLUE SHIELD
MI
01
—
103633
PREFERRED CHOICES
MI
05
—
209380410
—
MI
01
—
M009095
TRICARE
MI
01
—
P26654F
BLUE CARE NETWORK
MI
Enumeration date
01/26/2006
Last updated
02/23/2010
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