Provider Demographics
NPI:1083732614
Name:FIELD, MARJORIE E (PA)
Entity Type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:E
Last Name:FIELD
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:29992 NORTHWESTERN HWY STE C
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3292
Mailing Address - Country:US
Mailing Address - Phone:248-851-1430
Mailing Address - Fax:248-851-5182
Practice Address - Street 1:32255 NORTHWESTERN HWY STE 180
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1573
Practice Address - Country:US
Practice Address - Phone:248-355-0880
Practice Address - Fax:248-355-9232
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2019-07-31
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI4989453OtherMEDICARE PTAN