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General NPI Number Information
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NPI Number | 1033037700
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Entity Type | Individual
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Provider Name | MARINA MEDHAT GEORGE PA
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Gender | Female
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Dates
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Enumeration Date | 07/08/2026
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Last Update Date | 07/08/2026
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Provider Practice Location Address
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Address Line | 25500 MEADOWBROOK RD STE 208
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City | NOVI
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State | MI
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Zip | 48375-1882
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Country | US
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Telephone | 248-200-9240
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Fax |
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Provider Business Mailing Address
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Address Line | 20108 BALDWIN CIR
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City | HOLLY
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State | MI
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Zip | 48442-9395
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Country | US
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Telephone | 732-979-0489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5601014132TMP26
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License Number State | MI
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