DONNA JEAN MARVICSIN (NPI# 1811903784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811903784 |
| Entity Type | Individual |
| Full Name | DONNA JEAN MARVICSIN |
| Credential | NP |
| Practice Address |
3535 W 13 Mile Rd Suite 707 Royal Oak MI 48073-6770 |
| Practice Telephone | 2485510487 |
| Practice Fax Number | 2485513696 |
| Mailing Telephone | 2485510487 |
| Mailing Fax Number | 2485513696 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 4704135783 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
4704135783 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4578770 | 05 | |
| MI | BCBSM | 500F318190 | 01 |
| Street Address |
3535 W 13 MILE RD SUITE 707 |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48073-6770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750376877 | M Bassem Hosein Dekelbab | Pediatrics | 3535 W 13 Mile Rd, 707, Royal Oak, MI 48073-6770 | 2005-09-14 |
| 1639788029 | Moyosoreoluwa Morenike Laditan | Internal Medicine | 3535 W 13 Mile Rd, Medical Office Building, Suite Ll-35, Royal Oak, MI 48073-6770 | 2020-07-30 |
| 1952928780 | Julie Katia Morin-major | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-06-27 |
| 1336763382 | Reem Wassef | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-05 |
| 1942824271 | Ji Won Lee | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-06-02 |
| 1285257030 | Michael Maiden | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-05-27 |
| 1821611922 | Maria Kathryn Souphis | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-05-22 |
| 1710509393 | Yoshiko Nito | Pediatrics | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-05-18 |
| 1699397547 | Ashbina Pokharel | Internal Medicine | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-05-14 |
| 1720609746 | Geoffrey M Saham Pllc | Internal Medicine | 3535 W 13 Mile Rd, Royal Oak, MI 48073-6770 | 2020-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
| 1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| 1598389785 | Devika Aggarwal | Internal Medicine | 3601 W 13 Mile Road Beaumont Hospital- Royal Oak, Royal Oak, MI 48073 | 2020-06-03 |
| 1831713064 | Michael Morelli | Physical Medicine & Rehabilitation | Department of Physical Medicine and Rehabilitation, 3601 W 13 Mile Road, Royal Oak, MI 48073 | 2020-06-03 |
| 1134741895 | Kamil Sardarli | Internal Medicine | Beaumont Hospital - Royal Oak 3601 W Thirteen Mile Road, Royal Oak, MI 48073 | 2020-05-15 |
| 1245850171 | Dema Fawaz | Emergency Medicine | Beaumont Hospital, Royal Oak, Gme Office, 3601 W. 13 Mile Rd, Royal Oak, MI 48073 | 2020-04-21 |
| 1235771049 | Semaan Dentistry Pllc | Dentist | 30955 Woodward Ave Ste 105, Royal Oak, MI 48073 | 2019-10-14 |
| 1013560473 | Muhammad Waqas | Pediatrics | Beaumont Hospital Royal Oak, 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2019-07-24 |
| 1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
| Find all providers in zip 48073 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511452 | Corrie Lynn Williamson | Nurse Practitioner | 30701 Woodward Ave, Royal Oak, MI 48073-0987 | 2020-09-02 |
| 1508224056 | Shelley Salamango | Nurse Practitioner | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2016-01-29 |
| 1447527585 | Carolyn A Grabiel | Nurse Practitioner | 30701 Woodward Ave, Suite S-301, Royal Oak, MI 48073-0987 | 2011-11-17 |
| 1346481637 | Bella Yagolkovskaya | Nurse Practitioner | 3555 W 13 Mile Rd Ste N120, Royal Oak, MI 48073-6710 | 2009-03-16 |
| 1720094790 | Pamela Jennings | Nurse Practitioner | 3601 W 13 Mile Rd, Fsc, Royal Oak, MI 48073-6712 | 2006-07-31 |
| 1811913684 | Lisa Marie Paulun | Nurse Practitioner | 3601 W 13 Mile Rd, Fsc, Royal Oak, MI 48073-6712 | 2006-07-14 |
| 1356374540 | Constance M. Kangas | Nurse Practitioner | 3601 W 13 Mile Rd, Fsc, Royal Oak, MI 48073-6712 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851991061 | Sarah Elizabeth Barber | Nurse Practitioner | 12918 Lake Point Pass, Van Buren Twp, MI 48111-2243 | 2020-10-27 |
| 1730700881 | Kelsey Olinik | Nurse Practitioner | 22200 Barclay Dr, Novi, MI 48374-3874 | 2020-04-29 |
| 1467080705 | Jessica Nicole Heichel | Nurse Practitioner | 7729 Brass Creek Ct, Dexter, MI 48130-9384 | 2020-03-31 |
| 1114550506 | Katlyn Roberts | Nurse Practitioner | 60160 E 8 Mile Rd, South Lyon, MI 48178-9768 | 2020-02-13 |
| 1093351595 | Emily Janina Jamett | Nurse Practitioner | 31815 Southfield Rd Ste 10, Beverly Hills, MI 48025-5471 | 2019-11-20 |
| 1508410747 | Clorissa Diedrich | Nurse Practitioner | 829 N Center Ave Ste 130, Gaylord, MI 49735-1684 | 2019-07-25 |
| 1255895355 | Jessica Lynn Kata | Nurse Practitioner | 19229 Mack Ave Ste 28, Grosse Pointe Woods, MI 48236-2857 | 2019-01-23 |
| 1467934679 | Anita Lynn Riddle | Nurse Practitioner | 100 W. Vanburen Street, Battle Creek, MI 49017 | 2018-09-04 |
| 1285120634 | Alexandra Danko | Nurse Practitioner | 5500 Auto Club Dr Ste 160, Dearborn, MI 48126-2779 | 2018-07-09 |
| 1417442617 | Shelby Fredricks | Nurse Practitioner | 1205 S Mission St Ste 4, Mount Pleasant, MI 48858-3939 | 2018-06-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.