Healthcare Provider Details

I. General information

NPI: 1740846021
Provider Name (Legal Business Name): VICTORIA MICHAELA ESKAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 MCAULEY DR
YPSILANTI MI
48197-1051
US

IV. Provider business mailing address

27900 BARNES RD
DAMASCUS MD
20872-1535
US

V. Phone/Fax

Practice location:
  • Phone: 734-712-3456
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601009502
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: