Provider Demographics
NPI:1518087311
Name:KRCH, MARILYN BETH (MD)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:BETH
Last Name:KRCH
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 1:1006 SKYLINE CIR
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1838
Mailing Address - Country:US
Mailing Address - Phone:610-650-0398
Mailing Address - Fax:
Practice Address - Street 1:625 N POTTSTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1628
Practice Address - Country:US
Practice Address - Phone:601-903-0640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050524L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA47564373JMedicare ID - Type Unspecified
PAB82559Medicare UPIN