Healthcare Provider Details

I. General information

NPI: 1164468690
Provider Name (Legal Business Name): TONI TRATE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38215 W 10 MILE RD STE 8
FARMINGTON HILLS MI
48335-2866
US

IV. Provider business mailing address

38215 W 10 MILE RD STE 8
FARMINGTON HILLS MI
48335-2866
US

V. Phone/Fax

Practice location:
  • Phone: 248-474-0955
  • Fax:
Mailing address:
  • Phone: 248-474-0955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberTT10018
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: