Ivacko, Judith Ann
Ivacko, Judith Ann is an individual health care provider with primary practice located at 5301 E Huron River Dr , Ypsilanti MI 48197-1051. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Ivacko, Judith Ann can be contacted via phone (734) 712-3325.Contact Information
Primary practice address
5301 E Huron River Dr
Ypsilanti MI 48197-1051
Phone: (734) 712-3325
Fax: (734) 712-5525
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 43-01-058648 | Michigan |
Profile Details
| NPI number | 1285693622 |
|---|---|
| LBN Legal business name | Ivacko, Judith Ann |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Oct 14th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285693622 | NPPES |
| Michigan | MEDICAID | 4282589 |
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