Provider Demographics
NPI:1275866287
Name:MARSH JR., DAVID M (BA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:MARSH JR.
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1494 GRAVEL PIKE
Mailing Address - Street 2:
Mailing Address - City:GREEN LANE
Mailing Address - State:PA
Mailing Address - Zip Code:18054-2015
Mailing Address - Country:US
Mailing Address - Phone:215-234-9372
Mailing Address - Fax:215-234-9375
Practice Address - Street 1:1494 GRAVEL PIKE
Practice Address - Street 2:
Practice Address - City:GREEN LANE
Practice Address - State:PA
Practice Address - Zip Code:18054-2015
Practice Address - Country:US
Practice Address - Phone:215-234-9372
Practice Address - Fax:215-234-9375
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator