Provider Demographics
NPI:1598908956
Name:MARLON MICHEL MD PC
Entity Type:Organization
Organization Name:MARLON MICHEL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLON
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD MBA
Authorized Official - Phone:801-369-3535
Mailing Address - Street 1:1187 N 1100 E
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-4391
Mailing Address - Country:US
Mailing Address - Phone:801-369-3535
Mailing Address - Fax:801-607-2995
Practice Address - Street 1:1187 N 1100 E
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-4391
Practice Address - Country:US
Practice Address - Phone:801-369-3535
Practice Address - Fax:801-607-2995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty