Provider Demographics
NPI:1962688770
Name:PFEIFFER, MARILYN L (PT)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:L
Last Name:PFEIFFER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:L
Other - Last Name:WHETZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:201 DEFENSE HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8902
Mailing Address - Country:US
Mailing Address - Phone:667-204-7000
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:8109 RITCHIE HWY STE 600
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122
Practice Address - Country:US
Practice Address - Phone:443-481-1140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10002258225100000X
MD26126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist