Basic Information
| Provider Information | |||||||||
| NPI: | 1487601548 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIGNS | ||||||||
| FirstName: | MARLA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2390 MITCHELL PARK DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | PETOSKEY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497708965 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2314872250 | ||||||||
| FaxNumber: | 2313487972 | ||||||||
| Practice Location | |||||||||
| Address1: | 2390 MITCHELL PARK DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | PETOSKEY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497708965 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2314872250 | ||||||||
| FaxNumber: | 2313487972 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 01/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 5101008677 | MI | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 4372560 | 05 | MI | MEDICAID |