Douglas Lawrence Marsh, D.O.
Individual provider Active NPI Addiction Medicine (Family Medicine) Physician · Melvindale, MI
NPI 1790745966 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1790745966
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction Medicine (Family Medicine) Physician 207QA0401X
- License
- 5101007923 (MI)
- Practice address
- 18590 Allen Rd
Melvindale, MI 48122-1516 - Phone
- (313) 928-5000
- Fax
- (313) 928-2215
- NPI assigned
- Mar 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100625000055 | MI | Practitioner - General Practice |
3870624430 | Practice locations: Melvindale, MI |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101007923 | MI | MD | Addiction Medicine (Family Medicine) Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 5101007923 | MI | Yes |
Addresses
Primary practice location
18590 Allen Rd
Melvindale, MI 48122-1516
Mailing address
18590 Allen Rd
Melvindale, MI 48122-1516
Phone (313) 928-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5101007923 | Other | MI | STATE LICENSE |
Other providers in Melvindale, MI
- LKS Solutions Focused
- Loving Hearts Family Care
- Richard James Lucido
- Stephen P Lukas
- Kathryn Lyttleton
- Diane Gail Matz
- Melvindale Family Dentistry
- Melvindale Family Urgent Care PLLC
- Melvindale Pharmacy Inc.
- Melvindale Physical Therapy Specialists
All providers in Melvindale, MI · Addiction Medicine (Family Medicine) Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.