Provider Demographics
NPI:1235187691
Name:MARBLE, KIMBERLY RAE (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RAE
Last Name:MARBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-773-9904
Mailing Address - Fax:603-773-9905
Practice Address - Street 1:3 ALUMNI DR
Practice Address - Street 2:STE 402
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2119
Practice Address - Country:US
Practice Address - Phone:603-773-9904
Practice Address - Fax:603-773-9905
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD14955208200000X
NH9816208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHP00849476OtherRAILROAD MEDICARE
NH3076275Medicaid
G33981Medicare UPIN
NHRE421301Medicare PIN