Individual
DR. JOYCE K VACLAV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
25803 DRESCHFIELD AVE, GROSSE ILE, MI 48138-1602
(734) 692-6693
(734) 692-6693
Mailing address
25803 DRESCHFIELD AVE, GROSSE ILE, MI 48138-1602
(440) 934-6135
(440) 934-6147
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
5101009390
MI
208M00000X
Hospitalist Physician
5101009390
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00421
AETNA
MI
01
—
1158211544
BCBS
MI
05
—
1588664874
—
MI
05
—
4634734
—
MI
01
—
P00010001
MEDICARE PTAN WAYNE COUNTY
MI
01
—
P00040001
MEDICARE PTAN MONROE COUNTY
MI
Enumeration date
07/28/2005
Last updated
09/30/2019
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