Individual
CARLOS A MARCANO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301057357
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4213071
—
MI
05
—
4838645
—
MI
Enumeration date
05/26/2006
Last updated
07/09/2007
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