Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301035364 | MI |
Y | 111NI0900X | Internist | 4301035364 | MI |
N | 207RR0500X | Rheumatology | TI035364 | MI |
NPI | 1053480947 |
---|---|
Provider Name | Dr. Thomas F. Ignaczak |
First Address | Battle Creek, MI 49017-3398 |
Second Address | Battle Creek, MI 49017-3398 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1101301121 | BCBS (01) | MI |
3199719 | (05) | MI |
B03025 | (02) | MI |