Provider Demographics
NPI:1184679839
Name:ASNIS, MARVIN J (DO)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:J
Last Name:ASNIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:MERION
Mailing Address - State:PA
Mailing Address - Zip Code:19066
Mailing Address - Country:US
Mailing Address - Phone:610-667-0341
Mailing Address - Fax:610-667-0139
Practice Address - Street 1:508 WINDING WAY
Practice Address - Street 2:
Practice Address - City:MERION
Practice Address - State:PA
Practice Address - Zip Code:19066
Practice Address - Country:US
Practice Address - Phone:610-667-0341
Practice Address - Fax:610-667-0139
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS001340L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
D66357Medicare UPIN