Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marlon Nicdao

Individual provider Acute Care Nurse Practitioner · NPI 1225673114

Marlon Nicdao is a Nurse Practitioner in Detroit, Michigan. Qualified in 2019, 7 years ago. Practices with Providers Tek Inc, a 13-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
7
Licensed in
MI
In the registry since
2019
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Practice location Address checks out

3990 John R St
Detroit, MI 48201-2018
Phone: (313) 745-8040
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 4704289739 (MI)

Record details

NPI number1225673114
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 14, 2019
Last updated in NPPESNovember 14, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Providers Tek Inc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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