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NPI Code Detail

MEDICARE: MARC ALAIN LETELLIER MD

MEDICARE:   MARC ALAIN LETELLIER  MD
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
1174400000XSpecialist18410AZ

General Provider Information

NPI Number : 1841239340
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARC ALAIN LETELLIER MD
Provider Business Mailing Address
First Line : 4566 E INVERNESS AVE
Second Line :
City : MESA
State : AZ
Zip : 85206-4633
Country : US
Telephone Number : 480-730-1844
Fax Number : 480-730-1404
Provider Business Practice Location Address
First Line : 4566 E INVERNESS AVE
Second Line : #205
City : MESA
State : AZ
Zip : 85206-4633
Country : US
Telephone Number : 480-730-1844
Fax Number : 480-730-1404
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 07/09/2007

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Directions to “ MARC ALAIN LETELLIER MD” Practice Location

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