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NPI Code Detail

MEDICARE: NATHAN MARC STONE MA TLLP

MEDICARE: NATHAN MARC STONE MA TLLP
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
1213E00000XPodiatrist5901001438MI
2103T00000XPsychologist6301016540MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24858253120OTHERBCBS
3P80482OTHERBCN

General Provider Information

NPI Number : 1386753366
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN MARC STONE MA TLLP
Provider Business Mailing Address
First Line : 2075 W BIG BEAVER RD STE 520
Second Line :
City : TROY
State : MI
Zip : 48084-3442
Country : US
Telephone Number : 248-646-6659
Fax Number : 248-642-8645
Provider Business Practice Location Address
First Line : 2075 W BIG BEAVER RD STE 520
Second Line :
City : TROY
State : MI
Zip : 48084-3442
Country : US
Telephone Number : 248-646-6659
Fax Number : 248-642-8645
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 09/26/2019

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Directions to “ NATHAN MARC STONE MA TLLP” Practice Location

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