DR. MARIAN ROBERTA-BENTLEY FULLER (NPI# 1225053366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225053366 |
| Entity Type | Individual |
| Full Name | DR. MARIAN ROBERTA-BENTLEY FULLER |
| Other Name | MARIAN ROBERTA BENTLEY |
| Credential | MD |
| Practice Address |
250 Nelson Rd Ste 1 Ludington MI 49431-1993 |
| Mailing Address |
315 Oakgrove St Manistee MI 49660-1176 |
| Practice Telephone | 2318436767 |
| Mailing Telephone | 2313989266 |
| Mailing Fax Number | 2313989268 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2019-06-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 4301079496 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
250 NELSON RD STE 1 |
| City | LUDINGTON |
| State | MI |
| Zip Code | 49431-1993 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649893975 | Amber Nicole Coolman | Nurse Practitioner | 250 Nelson Rd Ste 1, Ludington, MI 49431-1993 | 2020-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972006690 | Marti Miller | Physical Therapist | 5916 Iris Rd., Ludington, MI 49431 | 2018-03-09 |
| 1700258670 | Leslie Hahn Ezdebski | Registered Nurse | 318 River St., Suite B, Manistee, MI 49431 | 2015-10-30 |
| 1477888618 | Kathleen M Tooman | Orthotic Fitter | 901 E Tinkham Avenue, Ludington, MI 49431 | 2009-10-06 |
| 1790831592 | Roger Edgren Ostling | Social Worker | 1027 N Rath, Ludington, MI 49431 | 2007-01-25 |
| 1487734364 | Kathryn Jean Niemeyer | Nurse Practitioner | 5 Atkinson Drive, Suite #207, Ludington, MI 49431 | 2006-10-16 |
| 1609986405 | Vivek Thakore | Clinic/Center | 5511 West Us 10 Hwy, Ludington, MI 49431 | 2006-08-30 |
| 1295747756 | Barbara Sleder | Nurse Practitioner | 1 North Atkinson Dr, Ludington, MI 49431 | 2006-08-13 |
| 1083653893 | William L Ingle Dc | Chiropractor | 321 N Jebavy Drive, Ludington, MI 49431 | 2006-06-06 |
| 1366429706 | Andrew S Riemer | Ophthalmology | 5959 Lawndale St, Ludington, MI 49431 | 2005-12-28 |
| 1699240085 | Toby Wessel, Lmsw, Pllc | Social Worker | 612 Sherman Oaks Dr, Ludington, MI 49431 | 2018-10-11 |
| Find all providers in zip 49431 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184683203 | Kang H Lee | Obstetrics & Gynecology | 7 N Atkinson Dr, Ste 113, Ludington, MI 49431-1953 | 2006-03-18 |
| 1982605648 | Dannie Joe Gentry Jr. | Obstetrics & Gynecology | 250 N Nelson Rd, Suite 1, Ludington, MI 49431-1942 | 2005-08-03 |
| 1366446130 | Margaret E Gustafson | Obstetrics & Gynecology | 250 Nelson Rd, Ste 1, Ludington, MI 49431-1993 | 2005-06-09 |
| 1689050783 | Memorial Medical Center of West Michigan | Obstetrics & Gynecology | 250 Nelson Rd, Ludington, MI 49431-1993 | 2015-07-31 |
| 1174908388 | Memorial Medical Center of West Michigan | Obstetrics & Gynecology | 913 E Ludington Ave, Ludington, MI 49431-2437 | 2015-07-29 |
| 1598957169 | Kang Hoon Lee Md PC | Obstetrics & Gynecology | 7 N Atkinson Dr, Suite 113, Ludington, MI 49431-1953 | 2007-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900096 | Youssef Derbala | Obstetrics & Gynecology | 15050 E Jefferson Ave Ste 102, Grosse Pointe Park, MI 48230-2050 | 2020-07-23 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1740808799 | Beyond Womens Care PC | Obstetrics & Gynecology | 455 S Livernois Rd Ste A12, Rochester Hills, MI 48307-2579 | 2020-07-07 |
| 1760009070 | Pamila Diwan, Md | Obstetrics & Gynecology | 30555 Southfield Rd Ste 180, Southfield, MI 48076-7700 | 2020-07-02 |
| 1972120962 | Tara Elizabeth Bjorklund | Obstetrics & Gynecology | 44405 Woodward Ave - H23, St. Joseph Mercy Oakland - Gme Office, Pontiac, MI 48341 | 2020-06-25 |
| 1194341198 | Kelcy L Welch | Obstetrics & Gynecology | 30445 Northwestern Hwy Ste 140, Farmington Hills, MI 48334-3174 | 2020-06-25 |
| 1457975476 | Lauren Nicole Holmes | Obstetrics & Gynecology | Gme Department, 1 Genesys Pkwy, Grand Blanc, MI 48439 | 2020-06-05 |
| 1780208272 | Whitney Nicole Buck | Obstetrics & Gynecology | 16001 W 9 Mile Rd Bldg Ste 401, Southfield, MI 48075-4818 | 2020-06-01 |
| 1245854652 | Rachel Shamoun | Obstetrics & Gynecology | 16001 W 9 Mile Rd Bldg Suite401, Southfield, MI 48075-4818 | 2020-06-01 |
| 1841811171 | Advanced Healthcare Associates, Pllc | Obstetrics & Gynecology | 25050 Outer Dr Ste 102, Lincoln Park, MI 48146-1293 | 2020-04-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.