Individual
MR. ACE JAMES TACDERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
17700 23 MILE RD, MACOMB, MI 48044-1154
(586) 868-9120
(586) 868-9136
Mailing address
17700 23 MILE RD, MACOMB, MI 48044-1154
(586) 868-9120
(586) 868-9136
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704234922
MI
Other
Enumeration date
05/28/2011
Last updated
11/12/2015
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