Provider Demographics
NPI:1457789752
Name:MICHAEL D MARION MD PC
Entity Type:Organization
Organization Name:MICHAEL D MARION MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARION
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-775-2415
Mailing Address - Street 1:310 N 850 E STE A
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-8623
Mailing Address - Country:US
Mailing Address - Phone:801-331-8554
Mailing Address - Fax:
Practice Address - Street 1:310 N 850 E STE A
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-8623
Practice Address - Country:US
Practice Address - Phone:801-331-8554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty