Provider Demographics
NPI:1093058786
Name:MCCREADY, TESS A (DO)
Entity Type:Individual
Prefix:
First Name:TESS
Middle Name:A
Last Name:MCCREADY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TESS
Other - Middle Name:
Other - Last Name:SOLANSKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1560 E MAPLE RD
Mailing Address - Street 2:SUITE 400 - CREDENTIALING
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1138
Mailing Address - Country:US
Mailing Address - Phone:248-581-5100
Mailing Address - Fax:248-581-5199
Practice Address - Street 1:1560 E MAPLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1138
Practice Address - Country:US
Practice Address - Phone:248-581-5100
Practice Address - Fax:248-581-5199
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101022625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine