Provider Demographics
NPI:1073730669
Name:DANK, JOEL RYAN (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:RYAN
Last Name:DANK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4602 DEPT
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122-0021
Mailing Address - Country:US
Mailing Address - Phone:906-225-3864
Mailing Address - Fax:906-225-3851
Practice Address - Street 1:405 US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:NEGAUNEE
Practice Address - State:MI
Practice Address - Zip Code:49866-1327
Practice Address - Country:US
Practice Address - Phone:906-475-6312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301086084207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1073730669Medicaid
MI08-0-52-1137-2OtherBCBS OF MICHIGAN
MIJD086084OtherBCBS OF MICHIGAN
MI0E26000079Medicare PIN