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General NPI Number Information
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NPI Number | 1669728739
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Entity Type | Individual
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Provider Name | TRACY KANE MD
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Gender | Female
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Dates
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Enumeration Date | 07/26/2012
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Last Update Date | 07/26/2012
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Provider Practice Location Address
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Address Line | 6071 W OUTER DR SGH EMERGENCY DEPT
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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 | 313-966-1090
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Fax |
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Provider Business Mailing Address
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Address Line | 16500 N PARK DR APT #418
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4735
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Country | US
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Telephone | 301-646-7747
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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 | 4301101347
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License Number State | MI
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