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General NPI Number Information
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NPI Number | 1013193788
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Entity Type | Organization
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Legal Business Name | LILLIAN MARZOUQ, M.D. P.C.
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Dates
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Enumeration Date | 01/12/2008
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Last Update Date | 10/20/2008
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Provider Practice Location Address
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Address Line | 145 ROCHDALE DR S SUITE B
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-2275
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Country | US
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Telephone | 248-652-1560
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Fax | 248-652-1591
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Provider Business Mailing Address
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Address Line | 49614 CRUSADER DR
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City | MACOMB
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State | MI
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Zip | 48044-1736
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Country | US
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Telephone | 248-763-2316
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LILLIAN MARZOUQ
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Credential | M.D.
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Telephone | 248-652-1560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LM063324
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License Number State | MI
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