Ace James Tacderas NP

NPI 1447544176 - Nurse Practitioner - 363LA2200X

NPI Details
NPI 1447544176
Gender Male
Enumeration Date 05/28/2011
Last Updated 11/12/2015
Entity Type Individual
Active Over 5 years ago
Practice Location
17700 23 MILE RD
MACOMB MI, 48044-1154, US
Phone (586) 868-9120
Fax (586) 868-9136
Business Location
17700 23 MILE RD
MACOMB MI, 48044-1154, US
Phone (586) 868-9120
Fax (313) 343-7864
Toxanomy
Taxonomy Code 363LA2200X
License State Michigan
License Number 4704234922
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According to our database, Mr. Ace James Tacderas NP NPI is 1447544176, taxonomy code is 363LA2200X and license number is 4704234922, license state is located at Michigan. Ace James Tacderas NP physically located at 17700 23 Mile Rd, Macomb MI, 48044-1154. NPI Number Ace James Tacderas NP has the Individual type.

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1447544176 NPI number is provided on an as is basis without warranty of any kind. 1447544176 is maintained by the National Plan & Provider Enumeration System. The contents of Ace James Tacderas NP are for informational purposes only.