Provider Demographics
NPI:1154063691
Name:LIOVAS, MARINA SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:SUE
Last Name:LIOVAS
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 1:24911 LITTLE MACK
Mailing Address - Street 2:SUITE C
Mailing Address - City:ST. CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080
Mailing Address - Country:US
Mailing Address - Phone:586-777-2050
Mailing Address - Fax:586-777-2189
Practice Address - Street 1:24911 LITTLE MACK
Practice Address - Street 2:SUITE C
Practice Address - City:ST. CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080
Practice Address - Country:US
Practice Address - Phone:586-777-2050
Practice Address - Fax:586-777-2189
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program