Provider Demographics
NPI:1821102401
Name:CURTIS, MARIANNE D (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:D
Last Name:CURTIS
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 1:1215 N SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-1811
Mailing Address - Country:US
Mailing Address - Phone:765-664-4430
Mailing Address - Fax:
Practice Address - Street 1:2400 W 2ND ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-3249
Practice Address - Country:US
Practice Address - Phone:765-668-2160
Practice Address - Fax:765-668-2246
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01049253208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ING91871Medicare UPIN