Provider Demographics
NPI:1811399082
Name:VALENTI, MARY C (PA)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:C
Last Name:VALENTI
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27901 WOODWARD AVE STE 300
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-0921
Practice Address - Country:US
Practice Address - Phone:248-545-0070
Practice Address - Fax:248-545-4850
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601007165363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant