# MARC L. CULLEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1659371326
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0102X | Surgical Critical Care Physician | 4301047728 | MI | — |
| 2086S0120X | Pediatric Surgery Physician | 4301047728 | MI | Yes |

## Other

- **Enumeration date:** 07/26/2005
- **Last updated:** 03/21/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000521507 | ANTHEM | OH |
| 01 | — | 04672 | PARAMOUNT | OH |
| 01 | — | 147948 | GLHP | — |
| 05 | — | 1816457 | — | MI |
| 01 | — | 2515273 | BCMH | OH |
| 05 | — | 2515273 | — | OH |
| 05 | — | 4115615 | — | MI |
| 01 | — | 4507190 | AETNA | OH |
| 05 | — | 5202214 | — | MI |
| 01 | — | 8161 | HEALTH PLAN OF MI | — |
| 01 | — | MC047728 | CHAMPUS-CHAMPUS | — |