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Individual

DIANE RENEE TRAENKLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1621 E BROOMFIELD ST, SUITE B, MOUNT PLEASANT, MI 48858-5427
(989) 772-3009
(989) 772-9301
Mailing address
1621 E BROOMFIELD ST, SUITE B, MT PLEASANT, MI 48858-5427
(989) 772-3009
(989) 772-0568

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5101011733
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0953701185
BCBSM
MI
01
1017077
MCLAREN HEALTH PLAN
MI
05
4824793-11
MI
Enumeration date
06/28/2006
Last updated
09/06/2012
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