Provider Demographics
NPI:1225071988
Name:KREBS, MARCIA L (MD)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:L
Last Name:KREBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:L
Other - Last Name:CHANTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:125 RED CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4272
Mailing Address - Country:US
Mailing Address - Phone:585-468-0600
Mailing Address - Fax:585-486-0649
Practice Address - Street 1:125 RED CREEK DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4272
Practice Address - Country:US
Practice Address - Phone:585-468-0600
Practice Address - Fax:585-486-0649
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253002207RH0003X, 207RX0202X
VA0101233497207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010183111Medicaid
G88402Medicare UPIN
VA010183111Medicaid