Provider Demographics
NPI:1235160334
Name:MASH, MARLENE J (MD)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:J
Last Name:MASH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:545 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1349
Mailing Address - Country:US
Mailing Address - Phone:484-351-8268
Mailing Address - Fax:484-351-8275
Practice Address - Street 1:545 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1349
Practice Address - Country:US
Practice Address - Phone:484-351-8268
Practice Address - Fax:484-351-8275
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2010-05-19
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Provider Licenses
StateLicense IDTaxonomies
PAMD030337E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C28206Medicare UPIN
033287Medicare ID - Type Unspecified