Provider Demographics
NPI:1669432977
Name:MARCHANT, ERIC ALAN (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:ALAN
Last Name:MARCHANT
Suffix:
Gender:M
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:P O BOX 829641
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0001
Mailing Address - Country:US
Mailing Address - Phone:267-370-5296
Mailing Address - Fax:215-230-3725
Practice Address - Street 1:595 W STATE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901
Practice Address - Country:US
Practice Address - Phone:267-885-1775
Practice Address - Fax:267-885-1757
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038631-E208600000X
PAMD38631-E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232649232OtherTAX INDENTIFICATION NUMBE
PAMA667676Medicare ID - Type UnspecifiedMEDICARE NUMBER
PA232649232OtherTAX INDENTIFICATION NUMBE