Organization
NESTOR B. HALICKI D.O.,P,C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NESTOR HALICKI D.O. (PRESIDENT)
(248) 674-2273
Entity
Organization
Contact information
Practice address
5616 HIGHLAND RD, WATERFORD, MI 48327-1926
(248) 674-2273
Mailing address
5616 HIGHLAND RD, WATERFORD, MI 48327-1926
(248) 674-2273
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101009374
MI
261QP2300X
Primary Care Clinic/Center
Primary
5101009374
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1735036
—
MI
Enumeration date
11/28/2005
Last updated
10/02/2007
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