Healthcare Provider Details

I. General information

NPI: 1568989705
Provider Name (Legal Business Name): MARQUIS D MITCHELL M&S TRANSPORT PLUS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7252 STUDEBAKER AVE
WARREN MI
48091-4983
US

IV. Provider business mailing address

8278 CHALMERS AVE
WARREN MI
48089-2329
US

V. Phone/Fax

Practice location:
  • Phone: 313-629-9397
  • Fax:
Mailing address:
  • Phone: 313-629-9397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: