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General NPI Number Information
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NPI Number | 1851643886
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Entity Type | Individual
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Provider Name | MAGGIE VARNEY
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Gender | Female
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 10/15/2012
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Provider Practice Location Address
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Address Line | 30126 HARPER AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48082-1648
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Country | US
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Telephone | 586-772-6656
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Fax | 586-772-6674
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Provider Business Mailing Address
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Address Line | 30126 HARPER AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48082-1648
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Country | US
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Telephone | 586-772-6656
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Fax | 586-772-6674
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 2701057283
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License Number State | MI
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