MEDICARE: MARION MCMICHAEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372600000X	Adult Companion

General Provider Information

NPI Number	:	1306653209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARION MCMICHAEL

Provider Business Mailing Address
First Line	:	13409 S WOODLAND RD APT 3
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-2867
Country	:	US
Telephone Number	:	216-326-8414
Fax Number	:

Provider Business Practice Location Address
First Line	:	13409 S WOODLAND RD APT 3
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-2867
Country	:	US
Telephone Number	:	216-326-8414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2024
Last Update Date	:	12/13/2024

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Directions to “ MARION MCMICHAEL ” Practice Location

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