Provider Demographics
NPI:1518315076
Name:BETTS-FIELDS, MARQUITA LASHONNE
Entity Type:Individual
Prefix:DR
First Name:MARQUITA
Middle Name:LASHONNE
Last Name:BETTS-FIELDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22200 W 11 MILE RD
Mailing Address - Street 2:STE 2433
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48037-7136
Mailing Address - Country:US
Mailing Address - Phone:248-260-8988
Mailing Address - Fax:
Practice Address - Street 1:22200 W 11 MILE RD
Practice Address - Street 2:STE 2433
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48037-7136
Practice Address - Country:US
Practice Address - Phone:248-260-8988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other