Provider Demographics
NPI:1033883269
Name:MARTIN S DUBRAVEC MD, PC
Entity Type:Organization
Organization Name:MARTIN S DUBRAVEC MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PHYSICIAN HEALTH CARE PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBRAVEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-779-4444
Mailing Address - Street 1:200 E MASON ST
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-1988
Mailing Address - Country:US
Mailing Address - Phone:231-779-4444
Mailing Address - Fax:
Practice Address - Street 1:200 E MASON ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-1988
Practice Address - Country:US
Practice Address - Phone:231-779-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty