Provider Demographics
NPI:1619148301
Name:FRED C MARSH MD, PC
Entity Type:Organization
Organization Name:FRED C MARSH MD, PC
Other - Org Name:FRED C MARSH MD FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-963-1826
Mailing Address - Street 1:2575 N ANKENY BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4708
Mailing Address - Country:US
Mailing Address - Phone:515-963-1826
Mailing Address - Fax:515-963-1827
Practice Address - Street 1:2575 N ANKENY BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4708
Practice Address - Country:US
Practice Address - Phone:515-963-1826
Practice Address - Fax:515-963-1827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty