Provider Demographics
NPI:1639151129
Name:SHABER, MARC L (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:L
Last Name:SHABER
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 1:200 RARITAN COMMONS RTE 31 NORTH
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1154
Mailing Address - Country:US
Mailing Address - Phone:908-782-5100
Mailing Address - Fax:908-782-0290
Practice Address - Street 1:200 RARITAN COMMONS RTE 31 NORTH
Practice Address - Street 2:SUITE 105
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1154
Practice Address - Country:US
Practice Address - Phone:908-782-5100
Practice Address - Fax:908-782-0290
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06375300207R00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA06375300OtherMEDICAL LICENSE
NJ60040253OtherHORIZON NJ DIRECT
877761OtherFOCUS
1504841OtherQUALCARE
1K5727OtherHEALTHNET
PA0521926000OtherINDEPENDECE BLUE CROSS
P2198796OtherOXFORD
2378887OtherAETNA
2922868009OtherCIGNA
NJ010063753NJ01OtherANTHEM
1807148OtherUNITED HEALTHCARE
2593373OtherGHI
NY533L01OtherEMPIRE
NJ7767404Medicaid
1504841OtherQUALCARE