Mardegian, Michelle L

Mardegian, Michelle L is an individual health care provider with primary practice located at 19401 Hubbard Dr , Dearborn MI 48126-2641. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Mardegian, Michelle L can be contacted via phone (313) 982-8100.

Contact Information

Primary practice address
19401 Hubbard Dr Dearborn MI 48126-2641
Phone: (313) 982-8100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5601002219 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601002219 Michigan

Profile Details

NPI number 1457476129
LBN Legal business name Mardegian, Michelle L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Jul 31st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457476129 NPPES
Michigan Other MM002219 MI LICENSE NUMBER

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