Individual
GERALD DUDEK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
827 E DIVISION ST, CADILLAC, MI 49601-2015
(231) 775-9741
(231) 775-9333
Mailing address
827 E DIVISION ST, CADILLAC, MI 49601-2015
(231) 775-9741
(231) 775-9333
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
GD009255
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0158300065
BLUE CROSS/SHIELD INDIVID
MI
01
—
0H36303
BLUE CROSS/SHIELD GROUP
MI
01
—
101653
PREFERRED CHOICE ID
MI
05
—
3083473
—
MI
Enumeration date
08/09/2005
Last updated
07/09/2007
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