Provider Demographics
NPI:1225031354
Name:MARSH, JONATHAN H (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:H
Last Name:MARSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:40 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-1138
Practice Address - Country:US
Practice Address - Phone:413-284-5400
Practice Address - Fax:413-284-5559
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261665207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3C0445OtherPHS
NY4537315OtherAETNA
NY6H9511OtherBCBS
NY171792OtherHIP
NYAA00884AOtherMDNY
NYAS561OtherOXFORD
NY0799561OtherCIGNA
NY5199838OtherGHI
NYF21270Medicare UPIN
NYF21270Medicare UPIN