DR. Michael Andrew Stack, M.D.

NPI #1932146685 in Ithaca, Michigan

Provider Information

NPI Number: 1932146685
Entity Type: Individual
Name: DR. Michael Andrew Stack, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Family Medicine
Credential: M.D.
Enumeration Date: Jun 1, 2006
Last Updated: Sep 6, 2012

Practice Location

Address: 121 N PINE RIVER ST
City: Ithaca
State: Michigan
ZIP Code: 48847-1039
Phone: (989) 875-5111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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