Provider Demographics
NPI:1396971263
Name:DANCIK, TAVIS ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:TAVIS
Middle Name:ANDREW
Last Name:DANCIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48012-0190
Mailing Address - Country:US
Mailing Address - Phone:248-847-2060
Mailing Address - Fax:248-301-9780
Practice Address - Street 1:30701 WOODWARD AVE STE 333
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-0987
Practice Address - Country:US
Practice Address - Phone:248-847-2060
Practice Address - Fax:248-301-9780
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA120868207RN0300X
MI4301104646207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology