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General NPI Number Information
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NPI Number | 1881815603
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Entity Type | Individual
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Provider Name | MICHELE K. TRAZKOVICH M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 17 SUNDAY CT.
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City | REISTERSTOWN
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State | MD
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Zip | 21136-6111
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Country | US
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Telephone | 410-526-2809
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Fax | 410-526-2809
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Provider Business Mailing Address
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Address Line | 17 SUNDAY CT.
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City | REISTERSTOWN
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State | MD
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Zip | 21136-6111
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Country | US
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Telephone | 410-526-2809
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Fax | 410-526-2809
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D0035400
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2084H0002X
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Taxonomy Name | Hospice and Palliative Medicine (Psychiatry & Neurology) Physician
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License Number | D0035400
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License Number State | MD
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