1841228699 NPI number — DR. CAROL LYNNE MARSH MD

Table of content: DR. CAROL LYNNE MARSH MD (NPI 1841228699)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841228699 NPI number — DR. CAROL LYNNE MARSH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARSH
Provider First Name:
CAROL
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MILLINER
Provider Other First Name:
ALAN
Provider Other Middle Name:
SPENCER
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1841228699
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
630 COPE ROAD
Provider Second Line Business Mailing Address:
SUITE E
Provider Business Mailing Address City Name:
KENNETT SQUARE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-444-5573
Provider Business Mailing Address Fax Number:
610-444-0991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
630 COPE ROAD
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
KENNETT SQUARE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-444-5573
Provider Business Practice Location Address Fax Number:
610-444-0991
Provider Enumeration Date:
06/29/2006

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: 208000000X , with the licence number:  MD021384E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: C10004171 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0026249000 . This is a "PERSONAL CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2321461560002 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 99341 . This is a "HEALTH ASSURANCE PENN INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0182426 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 99341 . This is a "COVENTRY HEALTH CARE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 99341 . This is a "HEALTH AMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 288943 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".




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