MEDICARE: MARATHON OIL COMPANY

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	363LF0000X	Family Nurse Practitioner	4704159126	MI

General Provider Information

NPI Number	:	1629392188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARATHON OIL COMPANY

Provider Business Mailing Address
First Line	:	1300 S FORT ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48217-1208
Country	:	US
Telephone Number	:	313-297-6003
Fax Number	:	313-843-9419

Provider Business Practice Location Address
First Line	:	1300 S FORT ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48217-1208
Country	:	US
Telephone Number	:	313-297-6003
Fax Number	:	313-843-9419

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	MR. PAUL STEVEN GURCZYNSKI
Credential	:	M.S.N. N.P.-C
Telephone Number	:	313-297-6003

Provider Enumeration Date	:	03/26/2010
Last Update Date	:	03/26/2010

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Directions to “MARATHON OIL COMPANY ” Practice Location

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