Healthcare Provider Details

I. General information

NPI: 1598783896
Provider Name (Legal Business Name): THOMAS A. DRABECKI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/08/2007
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

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number5101006391
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: