Provider Demographics
NPI:1821280223
Name:HUCK, PATRICK DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:DANIEL
Last Name:HUCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:SUITE J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:14650 E OLD US HIGHWAY 12
Practice Address - Street 2:STE 303
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118
Practice Address - Country:US
Practice Address - Phone:734-475-4177
Practice Address - Fax:734-475-3520
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.092448208600000X, 208600000X
MIEMC0003750208600000X
VA0101259430208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH506050OtherMEDICARE
OH0189953Medicaid
PA103096616Medicaid
OH0189953Medicaid