Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4301069199 | MI |
N | 207R00000X | Internist | 4301069199 | MI |
N | 111NI0900X | Internist | 4301069199 | MI |
NPI | 1114013711 |
---|---|
Provider Name | Dr. Martin Dubravec |
First Address | Cadillac, MI 49601 |
Second Address | Cadillac, MI 49601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 02/08/2021 |