Individual
DR. BASIL JOHN MARRELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
30855 JOHN R RD, MADISON HEIGHTS, MI 48071-5213
(248) 583-0100
(248) 583-4894
Mailing address
30855 JOHN R RD, MADISON HEIGHTS, MI 48071-5213
(248) 583-0100
(248) 583-4894
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5101006788
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114788740
—
MI
Enumeration date
12/22/2005
Last updated
12/28/2011
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