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NPI Code Detail

MEDICARE: MOLLY ANN MARLATT

MEDICARE: MOLLY ANN MARLATT
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
1363A00000XPhysician Assistant5601013116MI

General Provider Information

NPI Number : 1871397844
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY ANN MARLATT
Provider Business Mailing Address
First Line : 1827 NEWCASTLE RD
Second Line :
City : GROSSE POINTE WOODS
State : MI
Zip : 48236-1991
Country : US
Telephone Number : 734-664-0470
Fax Number :
Provider Business Practice Location Address
First Line : 45900 GEDDES RD
Second Line :
City : CANTON
State : MI
Zip : 48188-2306
Country : US
Telephone Number : 734-664-0470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2025
Last Update Date : 02/03/2026

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Directions to “ MOLLY ANN MARLATT ” Practice Location

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