Individual
STANLEY E DUDEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2121 ABBOTT RD, SUITE3, EAST LANSING, MI 48823-8535
(517) 351-6000
(517) 351-0473
Mailing address
2121 ABBOTT RD, SUITE3, EAST LANSING, MI 48823-8535
(517) 351-6000
(517) 351-0473
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301039222
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007002
MCLAUREN MEDICAID
MI
01
—
4414142
AETNA
MI
05
—
4457854
—
MI
Enumeration date
01/12/2007
Last updated
12/28/2007
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