Individual
MARKEETA WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15777 NORTHLINE RD STE 200, SOUTHGATE, MI 48195-2354
(734) 246-8100
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1848
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2009-01209
NC
208000000X
Pediatrics Physician
34176
SC
208000000X
Pediatrics Physician
Primary
4301085607
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341767
—
SC
01
—
SC99843365
MEDICARE PIN
SC
01
—
SC99845019
MEDICARE PIN
SC
Enumeration date
04/16/2007
Last updated
12/01/2022
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