Healthcare Provider Details

I. General information

NPI: 1568592343
Provider Name (Legal Business Name): THOMAS A. DRABECKI D.O.P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18285 E 10 MILE RD STE 150
ROSEVILLE MI
48066-5808
US

IV. Provider business mailing address

274 HILLCREST AVE
GROSSE POINTE FARMS MI
48236-3123
US

V. Phone/Fax

Practice location:
  • Phone: 586-778-1900
  • Fax: 586-778-9735
Mailing address:
  • Phone: 586-778-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number5101006391
License Number StateMI

VIII. Authorized Official

Name: DR. THOMAS ANTHONY DRABECKI
Title or Position: PRESIDENT
Credential: D.O,
Phone: 586-778-1900