Provider Demographics
NPI:1487601548
Name:SIGNS, MARLA M (DO)
Entity type:Individual
Prefix:DR
First Name:MARLA
Middle Name:M
Last Name:SIGNS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 MITCHELL PARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8965
Mailing Address - Country:US
Mailing Address - Phone:231-487-2250
Mailing Address - Fax:231-348-7972
Practice Address - Street 1:2390 MITCHELL PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8965
Practice Address - Country:US
Practice Address - Phone:231-487-2250
Practice Address - Fax:231-348-7972
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101008677208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4372560Medicaid
MI4372560Medicaid