Provider Demographics
NPI:1760481881
Name:ROEMMELT, MARNEY D (MD)
Entity Type:Individual
Prefix:
First Name:MARNEY
Middle Name:D
Last Name:ROEMMELT
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 1:14 BOW STREET
Mailing Address - Street 2:SAGE INTEGRATIVE MEDICINE
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2828
Mailing Address - Country:US
Mailing Address - Phone:603-583-4780
Mailing Address - Fax:603-821-0273
Practice Address - Street 1:14 BOW STREET
Practice Address - Street 2:SAGE INTEGRATIVE MEDICINE
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2828
Practice Address - Country:US
Practice Address - Phone:603-583-4780
Practice Address - Fax:603-821-0273
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11640207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE680702Medicare PIN