Healthcare Provider Details

I. General information

NPI: 1427006519
Provider Name (Legal Business Name): DARYL TYRONE PARKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 W MAIN ST
MILAN MI
48160-1213
US

IV. Provider business mailing address

55 W MAIN ST
MILAN MI
48160-1213
US

V. Phone/Fax

Practice location:
  • Phone: 734-439-1491
  • Fax: 734-439-7150
Mailing address:
  • Phone: 734-439-1491
  • Fax: 734-439-7150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301050950
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.080767
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: