Provider Demographics
NPI:1316154941
Name:RAY, MARION L (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MARION
Middle Name:L
Last Name:RAY
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:35640 SHANGRI LA CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-2264
Mailing Address - Country:US
Mailing Address - Phone:586-792-1720
Mailing Address - Fax:
Practice Address - Street 1:8600 CHICAGO RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-5546
Practice Address - Country:US
Practice Address - Phone:586-826-3300
Practice Address - Fax:586-826-3326
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601002441363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant