Healthcare Provider Details

I. General information

NPI: 1568326577
Provider Name (Legal Business Name): MARCIANA GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 NORTHLAND DR STE 250
MENDOTA HEIGHTS MN
55120-1189
US

IV. Provider business mailing address

PO BOX 7412452
CHICAGO IL
60674-2452
US

V. Phone/Fax

Practice location:
  • Phone: 888-402-0202
  • Fax:
Mailing address:
  • Phone: 248-607-0037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY MILLER
Title or Position: DIRECTOR OF REVENUE
Credential:
Phone: 248-331-7908