Individual
DR. RAYMOND D TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6087 E FILMORE RD, WALKERVILLE, MI 49459-9344
(231) 854-7655
(231) 854-7704
Mailing address
3944 BRENLOR DRIVE, HESPERIA, MI 49421
(231) 854-2999
(231) 854-2998
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
RT007455
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0855110514
BCBSM NURSING HOME
MI
05
—
4260509
—
MI
01
—
P00232094
RAIL ROAD MEDICARE
MI
Enumeration date
07/27/2005
Last updated
02/06/2024
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