Provider Demographics
NPI:1942250501
Name:MAROUN, MARIE-CLAIRE (MD)
Entity Type:Individual
Prefix:
First Name:MARIE-CLAIRE
Middle Name:
Last Name:MAROUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 BEECH ST STE 402
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2223
Mailing Address - Country:US
Mailing Address - Phone:413-534-2682
Mailing Address - Fax:413-534-2689
Practice Address - Street 1:575 BEECH ST STE 402
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-2223
Practice Address - Country:US
Practice Address - Phone:413-534-2682
Practice Address - Fax:413-534-2689
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080994207R00000X, 207RR0500X, 208M00000X
MA269301207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1942250501OtherNPI #
MI4862687-10Medicaid
MI70-0-F32947-0OtherBCBS CPIN #
MIMM080994OtherBCBSM
MI70-0-F32947-0OtherBCBS CPIN #
MI0P30630814Medicare PIN
MII53173Medicare UPIN