Provider Demographics
NPI:1548237423
Name:ZITIN, MARC A (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:A
Last Name:ZITIN
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:PO BOX 350
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-0350
Mailing Address - Country:US
Mailing Address - Phone:215-723-2333
Mailing Address - Fax:215-723-9112
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:LANKENAU MEDICAL BUILDING EAST SUITE 252
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-896-7360
Practice Address - Fax:610-896-5207
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038071E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA121910Medicaid
PA121910Medicaid
PA609751JH4Medicare PIN