Provider Demographics
NPI:1114975984
Name:MARBEY, MARK L (MD)
Entity Type:Individual
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First Name:MARK
Middle Name:L
Last Name:MARBEY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2315 MYRTLE ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-4602
Mailing Address - Country:US
Mailing Address - Phone:814-456-9197
Mailing Address - Fax:814-455-2765
Practice Address - Street 1:2315 MYRTLE ST
Practice Address - Street 2:SUITE 160
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-4602
Practice Address - Country:US
Practice Address - Phone:814-456-9197
Practice Address - Fax:814-455-2765
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-09-20
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Provider Licenses
StateLicense IDTaxonomies
PAMD432764208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
D07154Medicare UPIN