Individual
DR. MICHAEL L. MARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9 MEDICAL PARKWAY, #105, DALLAS, TX 75234-7852
(972) 243-4530
(972) 406-1950
Mailing address
9 MEDICAL PARKWAY, #105, DALLAS, TX 75234-7852
(972) 243-4530
(972) 406-1950
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
E4506
TX
207NS0135X
Procedural Dermatology Physician
E4506
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00D28C
GROUP MEDICARE
TX
01
—
D28C
GROUP BCBS
TX
Enumeration date
11/28/2006
Last updated
05/28/2009
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