MARCO DISTEFANO AT, ATC
NPI 1790354405
Specialist/Technologist - Athletic Trainer in University Center, MI

Q: What is Marco Distefano's NPI number?

The NPI number for Marco Distefano is 1790354405. It was assigned to this individual provider in the NPPES registry on June 18, 2021.

Q: What is Marco Distefano's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

Q: When was this NPI record last updated?

The NPPES record for Marco Distefano was last updated on June 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 18, 2021

7400 BAY RD, UNIVERSITY CENTER, MI 48710(989) 964-7233 Get Directions Write a Review

NPPES record last updated: June 18, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Marco Distefano At, Atc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARCO DISTEFANO AT, ATC (NPI 1790354405) is an individual athletic trainer provider in University Center, Michigan, licensed in Michigan (2601002258) and active in the NPI registry since June 2021.

NPPES Registry Identity

NPI1790354405

Entity TypeIndividualMale

Primary Taxonomy2255A2300X

Provider Legal NameMARCO DISTEFANOCredential: AT, ATC

Location Address7400 BAY RDUniversity Center, MI 48710-0001

Mailing Address48541 Hennings DrMacomb, MI 48044-5615 · (586) 549-3663

Phone(989) 964-7233

Sole ProprietorNo

Enumeration DateJune 18, 2021

NPPES CertifiedJune 18, 2021

✔ NPI 1790354405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2255A2300X

License✔ Licensed in MI · 2601002258

Definition

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

7400 BAY RD, University Center, MI 48710

Open in Google Maps ↗

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GABRIELLE ANN CAMERON

Student in an Organized Health Care Education/Training Program