Provider Demographics
NPI:1437316692
Name:MEYER, MARISA LYN (DO)
Entity Type:Individual
Prefix:DR
First Name:MARISA
Middle Name:LYN
Last Name:MEYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MARISA
Other - Middle Name:LYN
Other - Last Name:FRESCHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:P.O. BOX 191
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19723-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-4000
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:1600 ROCKLAND ROAD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:302-651-4200
Practice Address - Fax:302-651-6410
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMD00002080P0203X
NC2008-011382080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine