Provider Demographics
NPI:1053574632
Name:MARYJO VOELPEL DO FACOI PC
Entity type:Organization
Organization Name:MARYJO VOELPEL DO FACOI PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY JO
Authorized Official - Middle Name:K
Authorized Official - Last Name:VOELPEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-391-9220
Mailing Address - Street 1:3003 S BALDWIN RD STE A
Mailing Address - Street 2:
Mailing Address - City:ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48359-2358
Mailing Address - Country:US
Mailing Address - Phone:248-391-9220
Mailing Address - Fax:248-391-9224
Practice Address - Street 1:3003 S BALDWIN RD STE A
Practice Address - Street 2:
Practice Address - City:ORION
Practice Address - State:MI
Practice Address - Zip Code:48359-2358
Practice Address - Country:US
Practice Address - Phone:248-391-9220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARYJO VOELPEL D.O. FACOI PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-03
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMV006984207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4509816Medicaid
MI4509816Medicaid