Provider Demographics
NPI:1295769511
Name:THUR, MARA (MD)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:
Last Name:THUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2729 BLAIR MILL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1042
Mailing Address - Country:US
Mailing Address - Phone:215-672-2229
Mailing Address - Fax:215-672-6853
Practice Address - Street 1:2729 BLAIR MILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1042
Practice Address - Country:US
Practice Address - Phone:215-672-2229
Practice Address - Fax:215-672-6853
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD425201207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102907Medicare PIN