Provider Demographics
NPI:1922200070
Name:MARKS, AMY LAUREN (DO)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LAUREN
Last Name:MARKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4201 ST. ANTOINE UHC 6F MAILBOX# 226
Mailing Address - Street 2:UNIVERSITY PEDIATRICIANS
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-966-5051
Mailing Address - Fax:313-966-6618
Practice Address - Street 1:3535 W 13 MILE RD STE 305
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6770
Practice Address - Country:US
Practice Address - Phone:248-551-3070
Practice Address - Fax:248-551-3071
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2020-10-23
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Provider Licenses
StateLicense IDTaxonomies
MI5101018682208000000X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics