Drake, Tracy A

Drake, Tracy A is an individual health care provider with primary practice located at 26206 W 12 Mile Rd Suite 202, Southfield MI 48034-1754. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Drake, Tracy A can be contacted via phone (248) 827-7612.

Contact Information

Primary practice address
26206 W 12 Mile Rd Suite 202 Southfield MI 48034-1754
Phone: (248) 827-7612
Fax: (248) 827-7615
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Michigan

Profile Details

NPI number 1366532178
LBN Legal business name Drake, Tracy A
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Dec 13th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366532178 NPPES
Michigan Other 1106306332 BCBSM

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