Provider Demographics
NPI:1336377159
Name:MARIE-CLAIRE MAROUN M.D. PC
Entity Type:Organization
Organization Name:MARIE-CLAIRE MAROUN M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE-CLAIRE
Authorized Official - Middle Name:YOUSSEF
Authorized Official - Last Name:MAROUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-525-0626
Mailing Address - Street 1:326 MORAN RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-3435
Mailing Address - Country:US
Mailing Address - Phone:313-642-0625
Mailing Address - Fax:
Practice Address - Street 1:25631 LITTLE MACK AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2100
Practice Address - Country:US
Practice Address - Phone:586-473-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080994207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301080994OtherSTATE LICENSE
MI4301080994OtherSTATE LICENSE