Provider Demographics
NPI:1043216658
Name:MARCH, TEDD L (DO)
Entity Type:Individual
Prefix:DR
First Name:TEDD
Middle Name:L
Last Name:MARCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2252 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-4254
Mailing Address - Country:US
Mailing Address - Phone:734-682-5434
Mailing Address - Fax:734-244-5184
Practice Address - Street 1:2252 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-4254
Practice Address - Country:US
Practice Address - Phone:734-682-5434
Practice Address - Fax:734-244-5184
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MITM010259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI12617001OtherMEDICARE
MI4332439Medicaid
MI0N35390003Medicare ID - Type Unspecified