Individual
MARILYN VIERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW DO
Contact information
Practice address
2380 CEDAT ST, HOLT, MI 48842
(517) 742-4922
(517) 699-2904
Mailing address
3413 WOODS EDGE, OKEMOS, MI 48864-5901
(517) 349-3303
(517) 349-4374
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101011017
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C36097
TRAVELERS MEDICARE
MI
01
—
0C360971062
MEDICARE
MI
05
—
113331464
—
MI
Enumeration date
08/30/2006
Last updated
06/09/2015
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