Stanley E Dudek, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

4301039222 Issued in MI

Practice address

2121 Abbott Rd
Suite3
East Lansing, MI 48823-8535

Phone

(517) 351-6000

Fax

(517) 351-0473

NPI assigned

Jan 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michigan Surgical Center,LLC

  • Ambulatory Surgical Clinic/Center
  • East Lansing, MI
  • NPI 1154370146
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198800000000",
    "number": "1962552794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 ABBOTT RD",
            "address_2": "SUITE3",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238535",
            "telephone_number": "517-351-6000",
            "fax_number": "517-351-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 ABBOTT RD",
            "address_2": "SUITE3",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238535",
            "telephone_number": "517-351-6000",
            "fax_number": "517-351-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDEK",
        "first_name": "STANLEY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301039222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAUREN MEDICAID",
            "identifier": "1007002",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4457854",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4414142",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Drury, ATC
• Kierstin Drzal, PT
• Dubay Counseling & Consulting L.L.C.
• Stacie Dubay, MSW
• Christopher Dubie, DPT
• Morgan Dudley, M.D.
• Sarah Dufon
• Jennifer Dunahoo
• Erin Dunbar, MT-BC
• Nikia Duncan

• Otolaryngology Physician in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Otolaryngology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.