Individual
MARLON NICDAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-8040
Mailing address
4700 GREENFIELD RD STE 2E, DEARBORN, MI 48126-4124
(313) 740-1111
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704289739
MI
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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