Provider Demographics
NPI:1144200270
Name:ARNKOFF, MARC STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:STUART
Last Name:ARNKOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:26400 W 12 MILE RD
Mailing Address - Street 2:SUITE 70
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1700
Mailing Address - Country:US
Mailing Address - Phone:248-569-3009
Mailing Address - Fax:248-569-0670
Practice Address - Street 1:26400 W 12 MILE RD
Practice Address - Street 2:SUITE 70
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1700
Practice Address - Country:US
Practice Address - Phone:248-569-3009
Practice Address - Fax:248-569-0670
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301030781208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
38021204550001OtherCIGNA
38212045548075A003OtherTRICARE
B43866OtherHAP
4377904OtherAETNA
101103OtherCARE CHOICES
MI0635128OtherBCBS INDIVDUAL
MI109101910Medicaid
38212045548075A003OtherTRICARE