Individual
TODD MARSHALL ROARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5402
(586) 573-5580
Mailing address
333 E MAPLEHURST ST, FERNDALE, MI 48220-1374
(586) 573-5402
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704229946
MI
Other
Enumeration date
03/04/2008
Last updated
02/22/2021
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