Provider Demographics
NPI:1174829659
Name:FIKE, MARIANNE (MAC, LMT)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:FIKE
Suffix:
Gender:F
Credentials:MAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31388 DOGWOOD ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:DAGSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19939-4054
Mailing Address - Country:US
Mailing Address - Phone:302-236-5385
Mailing Address - Fax:
Practice Address - Street 1:32895 COASTAL HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:BETHANY BEACH
Practice Address - State:DE
Practice Address - Zip Code:19930-3782
Practice Address - Country:US
Practice Address - Phone:302-236-5385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECQ-0000015171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist