Provider Demographics
NPI:1609892470
Name:PURTELL, MARCELA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCELA
Middle Name:
Last Name:PURTELL
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 1:48462 BELL SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9625
Mailing Address - Country:US
Mailing Address - Phone:724-773-3404
Mailing Address - Fax:724-770-7940
Practice Address - Street 1:48462 BELL SCHOOL RD
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9625
Practice Address - Country:US
Practice Address - Phone:724-773-3404
Practice Address - Fax:724-770-7940
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425398207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2498239Medicaid
PA1011008360001Medicaid
PA085003LCKMedicare PIN
PA1011008360001Medicaid
I13133Medicare UPIN