Healthcare Provider Details

I. General information

NPI: 1740779479
Provider Name (Legal Business Name): MARIE DOMINICA ARNAOUT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 JACKSON RD STE 200
ANN ARBOR MI
48103-1889
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DR # J2000
ANN ARBOR MI
48105-9484
US

V. Phone/Fax

Practice location:
  • Phone: 734-761-2581
  • Fax: 734-761-9540
Mailing address:
  • Phone: 734-747-6766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101026749
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number5151011277
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101026749
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: