Provider Demographics
NPI:1306653209
Name:MCMICHAEL, MARION
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:MCMICHAEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13409 S WOODLAND RD APT 3
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2867
Mailing Address - Country:US
Mailing Address - Phone:216-326-8414
Mailing Address - Fax:
Practice Address - Street 1:13409 S WOODLAND RD APT 3
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2867
Practice Address - Country:US
Practice Address - Phone:216-326-8414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion