Provider Demographics
NPI:1629047444
Name:HURCHIK-MUNACO, NANCY A (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:A
Last Name:HURCHIK-MUNACO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:23800 ORCHARD LAKE ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2561
Mailing Address - Country:US
Mailing Address - Phone:248-476-2420
Mailing Address - Fax:248-476-9709
Practice Address - Street 1:23800 ORCHARD LAKE ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2561
Practice Address - Country:US
Practice Address - Phone:248-476-2420
Practice Address - Fax:248-476-9709
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINH045873207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
102846OtherCARE CHOICES PREFERRED CH
MI080028849OtherMEDICARE RAILROAD
C3261OtherMCARE
MI158852Medicaid
MI700F311630OtherBCBS GROUP