Healthcare Provider Details

I. General information

NPI: 1922054485
Provider Name (Legal Business Name): TRICITY MEDICAL CENTERS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 MONROE ST SUITE #209
DEARBORN MI
48124-2921
US

IV. Provider business mailing address

2040 MONROE ST SUITE #209
DEARBORN MI
48124-2921
US

V. Phone/Fax

Practice location:
  • Phone: 313-359-3800
  • Fax: 313-277-4100
Mailing address:
  • Phone: 313-359-3800
  • Fax: 313-277-4100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberCV053752
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberAG082782
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberSE019231
License Number StateMI

VIII. Authorized Official

Name: MS. NETTIE M NAPIER
Title or Position: ASST. ADMINSTRATOR
Credential:
Phone: 313-359-3800