Provider Demographics
NPI:1093864522
Name:CLOEREN, MARIANNE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:
Last Name:CLOEREN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:MS
Other - First Name:MARIANNE
Other - Middle Name:CLOEREN
Other - Last Name:DONOVAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:138 S ANN ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-1803
Mailing Address - Country:US
Mailing Address - Phone:443-466-0033
Mailing Address - Fax:
Practice Address - Street 1:11 S PACA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1791
Practice Address - Country:US
Practice Address - Phone:410-706-7464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD037093207R00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB68979Medicare UPIN