MEDICARE: DR. MARSON MA III M.D.

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	207P00000X	Emergency Medicine Physician	4301103797	MI
2	390200000X	Student in an Organized Health Care Education/Training Program	4301103797	MI
3	207P00000X	Emergency Medicine Physician	5315061677	MI

General Provider Information

NPI Number	:	1619317393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARSON MA III M.D.

Provider Business Mailing Address
First Line	:	22101 MOROSS RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48236-2148
Country	:	US
Telephone Number	:	313-343-3400
Fax Number	:	313-343-7620

Provider Business Practice Location Address
First Line	:	22101 MOROSS RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48236-2148
Country	:	US
Telephone Number	:	313-343-3400
Fax Number	:	313-343-7620

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

Provider Enumeration Date	:	06/26/2013
Last Update Date	:	03/03/2026

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Directions to “ DR. MARSON MA III M.D.” Practice Location

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