Provider Demographics
NPI:1326137340
Name:MARSH DINHAM, KEDDIE L (MD)
Entity Type:Individual
Prefix:
First Name:KEDDIE
Middle Name:L
Last Name:MARSH DINHAM
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 1:75 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-2303
Mailing Address - Country:US
Mailing Address - Phone:845-790-7999
Mailing Address - Fax:352-567-1974
Practice Address - Street 1:75 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-2303
Practice Address - Country:US
Practice Address - Phone:845-790-7999
Practice Address - Fax:352-567-1974
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00027443207V00000X
AL27443207V00000X
FLME122320207V00000X
KY47848207V00000X
ME22991207V00000X
MT60791207V00000X
FL122320207V00000X
NY276055207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009911469Medicaid