Individual
MARK MISHACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15945 19 MILE RD, STE 104, CLINTON TOWNSHIP, MI 48038-1147
(586) 228-6603
(586) 228-6613
Mailing address
15945 19 MILE RD, STE 104, CLINTON TOWNSHIP, MI 48038-1147
(586) 228-6603
(586) 228-6613
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MM062491
MI
Other
Enumeration date
08/12/2005
Last updated
09/08/2009
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