Marvic Malabanan
Nurse Practitioner, Acute Care in Royal Oak, MI. Individual provider (NPI-1).
NPI number1144841198
StatusActive
Last updated in NPPESSep 28, 2020
Details
- NPI
- 1144841198
- Entity type
- Individual (NPI-1)
- Name
- Marvic Malabanan
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 30, 2020
- Certification date
- Sep 28, 2020
- Last updated
- Sep 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2100X | Nurse Practitioner, Acute Care | 4704306606 | MI | Yes |
| 163WG0000X | Registered Nurse, General Practice | 4704306606 | MI |
Practice location
3601 W 13 Mile RdRoyal Oak, MI 48073-6712
Phone 248-898-5000
Mailing address
19467 Antago StLivonia, MI 48152-2513
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