Marc L Cullen, MD | |
Childrens Hospital Of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201 | |
(313) 831-3220 | |
(313) 831-3908 |
Full Name | Marc L Cullen |
---|---|
Gender | Male |
Speciality | Surgery - Pediatric Surgery |
Location | Childrens Hospital Of Michigan, Detroit, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659371326 | NPI | - | NPPES |
1816457 | Medicaid | MI | |
2515273 | Other | OH | BCMH |
4507190 | Other | OH | AETNA |
MC047728 | Other | CHAMPUS-CHAMPUS | |
000000521507 | Other | OH | ANTHEM |
MC047728 | Other | COMMERCIAL-COMMERCIAL NUMBER | |
2515273 | Medicaid | OH | |
5202214 | Medicaid | MI | |
147948 | Other | GLHP | |
8161 | Other | HEALTH PLAN OF MI | |
04672 | Other | OH | PARAMOUNT |
4115615 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2086S0102X | Surgery - Surgical Critical Care | 4301047728 (Michigan) | Secondary |
2086S0120X | Surgery - Pediatric Surgery | 4301047728 (Michigan) | Primary |
Entity Name | Ascension St John Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043478910 PECOS PAC ID: 3173424082 Enrollment ID: O20040115000409 |
Mailing Address | Practice Location Address |
---|---|
Marc L Cullen, MD Childrens Hospital Of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201 Ph: (313) 831-3220 | Marc L Cullen, MD Childrens Hospital Of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201 Ph: (313) 831-3220 |
Kaitlyn Dobesh, MD Surgery Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-2600 | |
Dr. Bellal Ali Joseph, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-3056 Fax: 313-916-9920 | |
Charles Edward Lucas, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 4160 John R St, Suite 615, Detroit, MI 48201 Phone: 313-745-4195 Fax: 313-993-8669 | |
Christopher Paul Cassell, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 22101 Moross Rd, Detroit, MI 48236 Phone: 313-343-4000 | |
Mitchell Ross Weaver, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-3156 Fax: 313-916-3023 | |
Alexander Marinica, Surgery Medicare: Accepting Medicare Assignments Practice Location: 6071 W Outer Dr Ste 121, Detroit, MI 48235 Phone: 313-966-3222 | |
Dr. Rachel Wobig, MD Surgery Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-5071 Fax: 313-916-9920 |