Provider Demographics
NPI:1285663567
Name:DAMEWOOD, MARIAN DEMARINIS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:DEMARINIS
Last Name:DAMEWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIAN
Other - Middle Name:TERESE
Other - Last Name:DEMARINIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2680 BLACKBERRY RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17315-3002
Mailing Address - Country:US
Mailing Address - Phone:717-292-4586
Mailing Address - Fax:
Practice Address - Street 1:2680 BLACKBERRY RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:PA
Practice Address - Zip Code:17315-3002
Practice Address - Country:US
Practice Address - Phone:717-292-4586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072781L207V00000X, 207VE0102X
MDD0026311207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100442OtherGEISINGER
PA01135902OtherCAPITAL BLUE CROSS-WMG
PA419529OtherHIGHMARK BLUE SHIELD
PA7300468OtherAETNA
PA021744OtherJOHNS HOPKINS
PA0465389000OtherAMERIHEALTH 65 PA
PA1144118OtherAMERIHEALTH MERCY-WMG
PA488612OtherMAMSI-WMG
PA114731OtherUNISON-WMG
PA1519841OtherGATEWAY-WMG
PA20096448OtherAMERIHEALTH MERCY - WMG
PA30139627OtherAMERIHEALTH MERCY - YHOBGYN
PA001824860Medicaid
MD308460OtherCAREFIRST MD BCBS
PA419529OtherHIGHMARK BLUE SHIELD
PA021744OtherJOHNS HOPKINS
PA0465389000OtherAMERIHEALTH 65 PA
PA114731OtherUNISON-WMG