Healthcare Provider Details

I. General information

NPI: 1972571446
Provider Name (Legal Business Name): JAMES MARLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 W CLARK RD SUITE 100
YPSILANTI MI
48197-0860
US

IV. Provider business mailing address

2100 COMMONWEALTH BLVD SUITE 202
ANN ARBOR MI
48105-1593
US

V. Phone/Fax

Practice location:
  • Phone: 734-434-0477
  • Fax: 734-434-6240
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301035327
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: