Provider Demographics
NPI:1588684229
Name:ARTHUR, MARSHA ANN (PA)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:ANN
Last Name:ARTHUR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:ANN
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4675 DEPARTMENT
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122-0021
Mailing Address - Country:US
Mailing Address - Phone:888-362-2500
Mailing Address - Fax:
Practice Address - Street 1:28800 RYAN RD
Practice Address - Street 2:SUITE 280
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-4272
Practice Address - Country:US
Practice Address - Phone:586-575-9444
Practice Address - Fax:586-575-9446
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601003346363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5601003346OtherLICENSE
1043424OtherNCCPA CERTIFICATE NUMBER
1043424OtherNCCPA CERTIFICATE NUMBER