Individual
DR. DANIEL TIMOTHY KULICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4472 MAIN ST, BROWN CITY, MI 48416-7908
(810) 346-2751
Mailing address
4472 MAIN ST, BROWN CITY, MI 48416-7908
(810) 346-2751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101016234
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11762285
CAQH ID
MI
01
—
1376695205
GROUP NPI
MI
01
—
5101016234
LICENSE
MI
01
—
5315024530
CONTROLLED SUBSTANCE LICENSE
MI
Enumeration date
04/23/2007
Last updated
03/07/2023
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