Provider Demographics
NPI:1407067366
Name:WRIGHT, DAKARA A RUCKER (MD)
Entity Type:Individual
Prefix:DR
First Name:DAKARA
Middle Name:A RUCKER
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DAKARA
Other - Middle Name:ANGELE
Other - Last Name:RUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:26380 BERG ROAD
Mailing Address - Street 2:APT 316
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034
Mailing Address - Country:US
Mailing Address - Phone:312-307-1319
Mailing Address - Fax:
Practice Address - Street 1:3031 W GRAND BLVD
Practice Address - Street 2:SUITE 800
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3046
Practice Address - Country:US
Practice Address - Phone:313-916-2171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087721207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology