Provider Demographics
NPI:1598779134
Name:TRAGER, ALLEN G (DO)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:G
Last Name:TRAGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:36123 SCHOOLCRAFT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1216
Mailing Address - Country:US
Mailing Address - Phone:734-793-6140
Mailing Address - Fax:865-560-8948
Practice Address - Street 1:401 S BALLENGER HWY
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3638
Practice Address - Country:US
Practice Address - Phone:734-464-0887
Practice Address - Fax:734-402-0254
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2018-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101006467207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1137685OtherHEALTHPLUS OF MICHIGAN
MICF9870OtherRAILROAD MEDICARE GROUP PIN
MI1432646Medicaid
MI0B511160OtherBCBSM
MI791061622OtherRAILROAD MEDICARE INDIVIDUAL PIN
MICF9870OtherRAILROAD MEDICARE GROUP PIN
MI0B511160OtherBCBSM