Individual
DANIEL J MIANECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6245 INKSTER RD, GARDEN CITY, MI 48135-4001
(734) 458-3412
(734) 677-7407
Mailing address
PO BOX 1108, ATTN: LYNDA THOMPSON, ANN ARBOR, MI 48106-1108
(734) 677-7400
(734) 677-7407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5101005939
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3158226625
BCBS PIN #
MI
05
—
4441569
—
MI
Enumeration date
07/19/2006
Last updated
07/08/2007
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