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General NPI Number Information
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NPI Number | 1629392188
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Entity Type | Organization
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Legal Business Name | MARATHON OIL COMPANY
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Dates
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Enumeration Date | 03/26/2010
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Last Update Date | 03/26/2010
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Provider Practice Location Address
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Address Line | 1300 S FORT ST
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City | DETROIT
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State | MI
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Zip | 48217-1208
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Country | US
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Telephone | 313-297-6003
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Fax | 313-843-9419
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Provider Business Mailing Address
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Address Line | 1300 S FORT ST
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City | DETROIT
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State | MI
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Zip | 48217-1208
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Country | US
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Telephone | 313-297-6003
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Fax | 313-843-9419
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MR. PAUL STEVEN GURCZYNSKI
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Credential | M.S.N. N.P.-C
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Telephone | 313-297-6003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704159126
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License Number State | MI
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