MEDICARE: MONICA VIRLAN

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	207Q00000X	Family Medicine Physician	4704313730	MI
2	363L00000X	Nurse Practitioner	4704313730	MI

General Provider Information

NPI Number	:	1740023654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA VIRLAN

Provider Business Mailing Address
First Line	:	PO BOX 3455
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48333-3455
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 3455
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48333-3455
Country	:	US
Telephone Number	:	313-663-3796
Fax Number	:

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

Provider Enumeration Date	:	06/18/2024
Last Update Date	:	08/08/2025

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Directions to “ MONICA VIRLAN ” Practice Location

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