Channell, Mariann M

Channell, Mariann M is an individual health care provider with primary practice located at 21711 Greater Mack Ave , St Clair Shores MI 48080-2418. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Channell, Mariann M can be contacted via phone (586) 774-0393.

Contact Information

Primary practice address
21711 Greater Mack Ave St Clair Shores MI 48080-2418
Phone: (586) 774-0393
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 4301043844 Michigan

Profile Details

NPI number 1225030596
LBN Legal business name Channell, Mariann M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Jun 3rd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225030596 NPPES
Michigan Other 180002293 MEDICARE RAILROAD

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