1841228699 NPI number — DR. CAROL LYNNE MARSH MD

Table of content: BRIAN HOWARD (NPI 1235871559)

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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