Doctor Name: | DAVID P TRACY |
NPI Number: | 1033121892 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 066578 |
Business Practice Address: | 1530 Pine Grove Ave Ste 7 Port Huron, MI - 48060 |
Business Phone Number: | 8109850029 |
Business Fax Number: | 8109850032 |
Mailing Address: | 1530 Pine Grove Ave, Ste 7 PORT HURON |
State: | MI |
Postal Code: | 48060 |
Phone Number: | 8109850029 |
Fax Number: | 8109850032 |
NPI Enumeration Date: | 08/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 066578 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |