Gregory A. Dudek, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

GD002916 Issued in MI

Practice address

117 Crocker Blvd
Mount Clemens, MI 48043-2505

Phone

(586) 465-7422

Fax

(586) 465-1480

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477580140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CROCKER BLVD",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432505",
            "telephone_number": "586-465-7422",
            "fax_number": "586-465-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 CROCKER BLVD",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432505",
            "telephone_number": "586-465-7422",
            "fax_number": "586-465-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDEK",
        "first_name": "GREGORY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "GD002916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2096664",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P42816",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald C Austin MD PC
• Christian Gabriel Dondonan, DO
• Dr Richard L Reinhardt PC
• Kaitlyn Brower Dressman, D.O
• Dubbs Chiropractic Office PLLC
• Mykhaylo Dudkin
• Joseph Ronald Dueweke, LMSW
• James Michael Dunn, CRNA
• Amelia Dunnigan
• Timothy John Dworkin, DO

• Chiropractor in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.