Healthcare Provider Details

I. General information

NPI: 1861490641
Provider Name (Legal Business Name): MARIA A MARKARIAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W GREENLAWN AVE STE 400
LANSING MI
48910-2898
US

IV. Provider business mailing address

3500 S CEDAR ST STE 116
LANSING MI
48910-4699
US

V. Phone/Fax

Practice location:
  • Phone: 517-483-7550
  • Fax: 517-882-4144
Mailing address:
  • Phone: 517-887-2511
  • Fax: 517-882-4144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number5101008940
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: