Provider Demographics
NPI:1841228699
Name:MARSH, CAROL LYNNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:LYNNE
Last Name:MARSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ALAN
Other - Middle Name:SPENCER
Other - Last Name:MILLINER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:630 COPE ROAD
Mailing Address - Street 2:SUITE E
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348
Mailing Address - Country:US
Mailing Address - Phone:610-444-5573
Mailing Address - Fax:610-444-0991
Practice Address - Street 1:630 COPE ROAD
Practice Address - Street 2:SUITE E
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348
Practice Address - Country:US
Practice Address - Phone:610-444-5573
Practice Address - Fax:610-444-0991
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021384E208000000X
DEC10004171208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
0026249000OtherPERSONAL CHOICE
2321461560002OtherCIGNA
99341OtherHEALTH ASSURANCE PENN INC
0182426OtherAETNA
DE99341OtherCOVENTRY HEALTH CARE
99341OtherHEALTH AMERICA
288943OtherMAMSI
99341OtherHEALTH ASSURANCE PENN INC