Provider Demographics
NPI:1700860087
Name:DELEWSKY, MARIE (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:
Last Name:DELEWSKY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 S ROCHESTER RD
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5160
Mailing Address - Country:US
Mailing Address - Phone:248-844-6000
Mailing Address - Fax:248-844-6159
Practice Address - Street 1:3950 S ROCHESTER RD
Practice Address - Street 2:SUITE 1200
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5160
Practice Address - Country:US
Practice Address - Phone:248-844-6000
Practice Address - Fax:248-844-6159
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001394213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2845800Medicaid
MI0H26361Medicare ID - Type Unspecified
MI2845800Medicaid
MIP51480002Medicare PIN