Individual
DUSTIN G NOWACEK
Active
Individual
DUSTIN G NOWACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
4301092655
MI
207T00000X
Neurological Surgery Physician
4301092655
MI
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
4301092655
MI
2084N0400X
Neurology Physician
Primary
4301092655
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699934604
—
MI
Enumeration date
06/04/2008
Last updated
11/30/2023
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