Individual
DR. TRENT MICHAEL TENNYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19401 HUBBARD DR, DEARBORN, MI 48126-2641
(313) 982-8369
Mailing address
19401 HUBBARD DR, DEARBORN, MI 48126-2641
(313) 982-8369
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
25MA11085700
NJ
207P00000X
Emergency Medicine Physician
Primary
4301113830
MI
207P00000X
Emergency Medicine Physician
MT201280
PA
Other
Enumeration date
06/22/2012
Last updated
06/30/2021
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