JERRY A DANCIK NPI 1528492212

NPI Information

NPI: 1528492212
Provider Name: JERRY A DANCIK

Doing Business As: RENAL REDUX

Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 23D2079663

Address:
1455 S LAPEER RD
SUITE 207
LAKE ORION, MI
ZIP 48360
Phone: (248) 690-9946
Get Directions

JERRY A DANCIK is a nephrology internal medicine in Lake Orion, MI. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. JERRY A DANCIK NPI is 1528492212. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Renal Redux.

The provider's business location address is:

1455 S LAPEER RD
SUITE 207
LAKE ORION, MI
ZIP 48360-467
Phone: (248) 690-9946
Fax: (248) 690-9956

The provider's authorized official is Jerry Allen Dancik .
The authorized official title is Ceo and has the following contact phone number (248) 690-9946.

The CLIA number assigned to this NPI record is 23D2079663 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2013 and was last updated on 12/12/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RN0300X	Internal Medicine	Nephrology	4301033510	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	4218461	MEDICAID	MICHIGAN
2	E26055	MEDICARE UPIN	MICHIGAN
3	4095853	MEDICAID	MICHIGAN
4	M54550002	MEDICARE UPIN	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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