Healthcare Provider Details

I. General information

NPI: 1457410375
Provider Name (Legal Business Name): ERICA LYN MARKOVITZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1194 OAK VALLEY DR STE 80B
ANN ARBOR MI
48108-8942
US

IV. Provider business mailing address

PO BOX 639295
CINCINNATI OH
45263-9295
US

V. Phone/Fax

Practice location:
  • Phone: 734-975-5000
  • Fax:
Mailing address:
  • Phone: 248-824-6000
  • Fax: 855-618-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301080006
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301080006
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: