1144200270 NPI number — DR. MARC STUART ARNKOFF M.D.

Table of content: KAREN FORD (NPI 1336537224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144200270 NPI number — DR. MARC STUART ARNKOFF M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARNKOFF
Provider First Name:
MARC
Provider Middle Name:
STUART
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144200270
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26400 W 12 MILE RD
Provider Second Line Business Mailing Address:
SUITE 70
Provider Business Mailing Address City Name:
SOUTHFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48034-1700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-569-3009
Provider Business Mailing Address Fax Number:
248-569-0670

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26400 W 12 MILE RD
Provider Second Line Business Practice Location Address:
SUITE 70
Provider Business Practice Location Address City Name:
SOUTHFIELD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48034-1700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-569-3009
Provider Business Practice Location Address Fax Number:
248-569-0670
Provider Enumeration Date:
01/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  01094465A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X , with the licence number: 4301030781 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 300116410 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4377904 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0635128 . This is a "BCBS INDIVDUAL" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 38212045548075A003 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: B43866 . This is a "HAP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 38021204550001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 101103 . This is a "CARE CHOICES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 109101910 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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