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Individual

TARA M BRESLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5320 ELLIOTT DR, SUITE 203, YPSILANTI, MI 48197-1032
(734) 475-4177
(734) 712-1744
Mailing address
24 FRANK LLOYD WRIGHT DR, PO BOX 0446 LOBBY J, ANN ARBOR, MI 48105-9484

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
42352
WI
208600000X
Surgery Physician
4301089319
MI
2086X0206X
Surgical Oncology Physician
036.131860
IL
2086X0206X
Surgical Oncology Physician
Primary
4301089319
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33341100
WI
Enumeration date
04/12/2006
Last updated
06/02/2016
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