Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301098306 | MI |
N | 111NI0900X | Internist | 4301098306 | MI |
N | 207RH0003X | Hematology & Oncology | 4301098306 | MI |
Y | 207RX0202X | Medical Oncology | 4301098306 | MI |
NPI | 1174816045 |
---|---|
Provider Name | Frank C. Cackowski |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2011 |
Last Update Date | 03/08/2017 |