Provider Demographics
NPI:1992959563
Name:SEFCIK, DONALD J (DO)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:SEFCIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A308 EAST FEE HALL
Mailing Address - Street 2:COM DEAN'S OFFICE
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824
Mailing Address - Country:US
Mailing Address - Phone:517-355-9616
Mailing Address - Fax:
Practice Address - Street 1:138 SERVICE RD STE A109
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-1376
Practice Address - Country:US
Practice Address - Phone:517-355-1300
Practice Address - Fax:517-355-1710
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018026207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1992959563Medicaid
MIC36088110Medicare PIN