Organization
JERRY A DANCIK
Active
Other names
Renal Redux
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY ALLEN DANCIK M.D. (CEO)
(248) 690-9946
Entity
Organization
Contact information
Practice address
1455 S LAPEER RD, SUITE 207, LAKE ORION, MI 48360-1467
(248) 690-9946
(248) 690-9956
Mailing address
1455 S LAPEER RD, SUITE 207, LAKE ORION, MI 48360-1467
(248) 690-9946
(248) 690-9956
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301033510
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4095853
—
MI
05
—
4218461
—
MI
Enumeration date
08/29/2013
Last updated
12/12/2013
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