Individual
MR. MARK L PASSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
20331 FARMINGTON RD, LIVONIA, MI 48152-1411
(248) 474-2288
Mailing address
20331 FARMINGTON RD, LIVONIA, MI 48152-1411
(242) 474-2288
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704248035
MI
363LF0000X
Family Nurse Practitioner
Primary
4704248035
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4704248035
MI
Other
Enumeration date
06/27/2014
Last updated
12/09/2025
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