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General NPI Number Information
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NPI Number | 1225482326
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Entity Type | Individual
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Provider Name | ASHLEY CHRISTINE DA PRA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/15/2016
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 6071 W OUTER DR
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City | DETROIT
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State | MI
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Zip | 48235-2624
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Country | US
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Telephone | 313-966-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 2915 W 13 MILE RD APT 405
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City | ROYAL OAK
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State | MI
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Zip | 48073-2944
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Country | US
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Telephone | 517-304-1983
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4301117314
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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