Organization
JOYCE K VACLAV DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOYCE K VACLAV DO (OWNER/PHYSICIAN)
(734) 558-8891
Entity
Organization
Contact information
Practice address
25803 DRESCHFIELD AVE, GROSSE ILE, MI 48138-1602
(440) 934-6135
(440) 934-6147
Mailing address
25803 DRESCHFIELD AVE, GROSSE ILE, MI 48138-1602
(440) 934-6135
(440) 934-6147
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
5101009390
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00421
AETNA
MI
01
—
1158211544
BCBS
MI
05
—
1538101720
—
MI
01
—
440H203220
BCBS GROUP
MI
05
—
4634716
—
MI
05
—
4634734
—
MI
01
—
DD5444
RAILROAD MEDICARE
MI
01
—
E77788
HAP
MI
Enumeration date
06/12/2006
Last updated
01/27/2021
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