Healthcare Provider Details

I. General information

NPI: 1528210838
Provider Name (Legal Business Name): TRACY D BRADY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 HEALTH PKWY
MOUNT PLEASANT MI
48858-9342
US

IV. Provider business mailing address

2940 HEALTH PKWY
MOUNT PLEASANT MI
48858-9342
US

V. Phone/Fax

Practice location:
  • Phone: 989-779-5262
  • Fax:
Mailing address:
  • Phone: 989-779-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60945861
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301088426
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME154970
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: