Provider Demographics
NPI:1669574315
Name:KURSIK, NANCY J (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:J
Last Name:KURSIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8483 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1840
Mailing Address - Country:US
Mailing Address - Phone:810-694-7955
Mailing Address - Fax:810-579-7004
Practice Address - Street 1:8483 HOLLY RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1840
Practice Address - Country:US
Practice Address - Phone:810-694-7955
Practice Address - Fax:810-694-6955
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301052568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3235360Medicaid
MIM23560040Medicare PIN
MIB43407Medicare UPIN