1700971827 NPI number — DR. MARCI LYNN DREES M.D.

Table of content: DR. MARCI LYNN DREES M.D. (NPI 1700971827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700971827 NPI number — DR. MARCI LYNN DREES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DREES
Provider First Name:
MARCI
Provider Middle Name:
LYNN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DREES
Provider Other First Name:
MARCIA
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1700971827
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/29/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4755 OGLETOWN-STANTON RD
Provider Second Line Business Mailing Address:
SUITE 2E70
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19718
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-733-5602
Provider Business Mailing Address Fax Number:
302-733-6386

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 SUNNYSIDE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SMYRNA
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19977-1752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-653-1900
Provider Business Practice Location Address Fax Number:
302-653-1901
Provider Enumeration Date:
10/04/2006

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: 207RI0200X , with the licence number:  C1-0008371 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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