Provider Demographics
NPI:1396971263
Name:DANCIK, TAVIS ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:TAVIS
Middle Name:ANDREW
Last Name:DANCIK
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:32121 WOODWARD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6237
Mailing Address - Country:US
Mailing Address - Phone:248-690-9946
Mailing Address - Fax:248-268-3661
Practice Address - Street 1:32121 WOODWARD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6237
Practice Address - Country:US
Practice Address - Phone:248-690-9946
Practice Address - Fax:248-268-3661
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2015-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA120868207RN0300X
MI4301104646207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology