Provider Demographics
NPI:1376552935
Name:PLATT, MARC L (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:L
Last Name:PLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4416
Mailing Address - Country:US
Mailing Address - Phone:610-692-4382
Mailing Address - Fax:610-430-6820
Practice Address - Street 1:531 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4416
Practice Address - Country:US
Practice Address - Phone:610-692-4382
Practice Address - Fax:610-430-6820
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426324207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4024233OtherAETNA
PA5540815OtherCIGNA
PA1752007OtherHIGHMARK
PAP00282467OtherTRAVERLERS MEDICARE
PA2417712000OtherKEYSTONE
PA5540815OtherCIGNA
PA4024233OtherAETNA