Provider Demographics
NPI:1831937507
Name:CAMPUS CARE MD PLLC
Entity type:Organization
Organization Name:CAMPUS CARE MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-255-1053
Mailing Address - Street 1:2309 BROCKMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4702
Mailing Address - Country:US
Mailing Address - Phone:734-255-1053
Mailing Address - Fax:734-252-0350
Practice Address - Street 1:2309 BROCKMAN BLVD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4702
Practice Address - Country:US
Practice Address - Phone:734-255-1053
Practice Address - Fax:734-252-0350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care