Provider Demographics
NPI:1568592343
Name:THOMAS A. DRABECKI D.O.P.C.
Entity Type:Organization
Organization Name:THOMAS A. DRABECKI D.O.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DRABECKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO,
Authorized Official - Phone:586-778-1900
Mailing Address - Street 1:274 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-3123
Mailing Address - Country:US
Mailing Address - Phone:586-778-1900
Mailing Address - Fax:
Practice Address - Street 1:18285 E 10 MILE RD STE 150
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-5808
Practice Address - Country:US
Practice Address - Phone:586-778-1900
Practice Address - Fax:586-778-9735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006391207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5500082Medicare ID - Type Unspecified
MIB43778Medicare UPIN