Individual
DR. REGINA T NOACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(313) 966-3300
Mailing address
4201 SAINT ANTOINE ST STE 3R, DETROIT, MI 48201-2153
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301071403
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301071403
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103490184
—
MI
05
—
104144546
—
MI
01
—
RN071403
BC/BS OF MI
MI
Enumeration date
03/17/2006
Last updated
06/17/2010
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