Provider Demographics
NPI:1528098670
Name:MICHELS, MARGUERITE INGE (NP)
Entity type:Individual
Prefix:MS
First Name:MARGUERITE
Middle Name:INGE
Last Name:MICHELS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:MARGUERITE
Other - Middle Name:
Other - Last Name:NATOLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43800 GARFIELD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1136
Mailing Address - Country:US
Mailing Address - Phone:586-228-4652
Mailing Address - Fax:586-228-4520
Practice Address - Street 1:1150 E LANTZ ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48203-1376
Practice Address - Country:US
Practice Address - Phone:313-368-4139
Practice Address - Fax:313-368-4470
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704106974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4874249Medicaid
MI4704106974OtherMICHIGAN LICENSE NUMBER
MI4704106974OtherMICHIGAN LICENSE NUMBER