Individual
DR. DANIEL E TACKABURY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3789 HURON ST, NORTH BRANCH, MI 48461-8117
(810) 688-3093
(810) 688-3964
Mailing address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-1000
(810) 342-1590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301070116
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0988276
HEALTH PLUS
MA
01
—
253174
MCLAREN HEALTH PLAN
MA
05
—
4226712
—
MI
01
—
6872693001
CIGNA
MI
01
—
7936230
AETNA
MI
01
—
C7436
MCARE
MA
01
—
H21189
HEALTH ALLIANCE PLAN
MI
Enumeration date
11/09/2005
Last updated
07/08/2007
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