Provider Demographics
NPI:1467258103
Name:AIKINS, MICHAEL ROBERT MARLING
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ROBERT MARLING
Last Name:AIKINS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3493 BAYWATCH DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-6104
Mailing Address - Country:US
Mailing Address - Phone:707-338-5198
Mailing Address - Fax:
Practice Address - Street 1:3493 BAYWATCH DR
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-6104
Practice Address - Country:US
Practice Address - Phone:707-338-5198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer