Provider Demographics
NPI:1619046513
Name:MAROUF, LINETTA LOVEY (PA-C)
Entity Type:Individual
Prefix:
First Name:LINETTA
Middle Name:LOVEY
Last Name:MAROUF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINETTA
Other - Middle Name:LOVEY
Other - Last Name:ALLUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 1187
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-1187
Mailing Address - Country:US
Mailing Address - Phone:248-651-0800
Mailing Address - Fax:248-651-7341
Practice Address - Street 1:1555 SOUTH BLVD E STE 320
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5663
Practice Address - Country:US
Practice Address - Phone:248-651-0800
Practice Address - Fax:248-651-7341
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601004761363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical