Provider Demographics
NPI:1639338148
Name:BRIGG, MARILEE B (PA)
Entity Type:Individual
Prefix:
First Name:MARILEE
Middle Name:B
Last Name:BRIGG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MARILEE
Other - Middle Name:B
Other - Last Name:GOLDBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7206
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19101-7206
Mailing Address - Country:US
Mailing Address - Phone:800-355-0808
Mailing Address - Fax:610-934-2862
Practice Address - Street 1:9000 FRANKLIN SQUARE DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3901
Practice Address - Country:US
Practice Address - Phone:443-777-7068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant