Provider Demographics
NPI:1891100863
Name:DEAMES, MARIAN (MD)
Entity type:Individual
Prefix:
First Name:MARIAN
Middle Name:
Last Name:DEAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9434
Mailing Address - Country:US
Mailing Address - Phone:734-856-5494
Mailing Address - Fax:734-856-7184
Practice Address - Street 1:3175 SMITH RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-9434
Practice Address - Country:US
Practice Address - Phone:734-856-5494
Practice Address - Fax:734-856-7184
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2017-0552207Q00000X
MI4301105369207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine