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Individual

MICHAEL E STACHECKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
5885 S MAIN ST STE 3, CLARKSTON, MI 48346-2981
(248) 620-1720
(248) 620-1740
Mailing address
5885 S MAIN ST STE 3, CLARKSTON, MI 48346-2981
(248) 620-1720
(248) 620-1740

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301058225
MI
208000000X
Pediatrics Physician
4301058225
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1106360120
BCBS
MI
05
3162002
MI
Enumeration date
02/14/2006
Last updated
06/01/2021
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