Provider Demographics
NPI:1861640997
Name:DOE, MARIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:
Last Name:DOE
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 1:30 E RIVER PARK PL W
Mailing Address - Street 2:STE 320
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1539
Mailing Address - Country:US
Mailing Address - Phone:559-797-1862
Mailing Address - Fax:
Practice Address - Street 1:30 E RIVER PARK PL W
Practice Address - Street 2:STE 320
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-1539
Practice Address - Country:US
Practice Address - Phone:559-797-1862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105109207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine