Organization
STEPHEN B REZNICEK M.D. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN B REZNICEK M.D. (PRESIDENT)
(231) 779-2565
Entity
Organization
Contact information
Practice address
1011 SUNNYSIDE DR, CADILLAC, MI 49601-8735
(231) 779-2565
(231) 775-0744
Mailing address
1011 SUNNYSIDE DR, CADILLAC, MI 49601-8735
(231) 779-2565
(231) 775-0744
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3408300152
BLUE CROSS
MI
Enumeration date
10/02/2007
Last updated
01/09/2008
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