Organization
MARILYN VIERA MSW DO PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAILYN VIERA MSW DO (OWNER)
(517) 482-8735
Entity
Organization
Contact information
Practice address
1515 LAKE LANSING RD, SUITE C-1, LANSING, MI 48912-3753
(517) 482-8735
(517) 482-8744
Mailing address
1515 LAKE LANSING RD, SUITE C-1, LANSING, MI 48912-3753
(517) 482-8735
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101011017
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0853302285
BCBS OF MICHIGAN
MI
Enumeration date
08/30/2006
Last updated
08/22/2020
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