Individual
DAVID P TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1530 PINE GROVE AVE, STE 7, PORT HURON, MI 48060
(810) 985-0029
(810) 985-0032
Mailing address
1530 PINE GROVE AVE, STE 7, PORT HURON, MI 48060
(810) 985-0029
(810) 985-0032
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
066578
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4094810
—
MI
Enumeration date
08/12/2006
Last updated
07/08/2007
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