Provider Demographics
NPI:1316767437
Name:MARKO, LAUREN (PA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MARKO
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Gender:
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:9468 S SAGINAW RD STE B
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-9669
Mailing Address - Country:US
Mailing Address - Phone:810-445-5500
Mailing Address - Fax:810-445-5600
Practice Address - Street 1:9468 S SAGINAW RD STE B
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-9669
Practice Address - Country:US
Practice Address - Phone:810-445-5500
Practice Address - Fax:810-445-5600
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2025-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601012860363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant