Provider Demographics
NPI:1720104565
Name:DEHLINGER, MARIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:
Last Name:DEHLINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MARIAN
Other - Middle Name:
Other - Last Name:PESECKIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 N. MAGNOLIA ST.
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29151-4943
Mailing Address - Country:US
Mailing Address - Phone:803-775-9364
Mailing Address - Fax:803-773-6615
Practice Address - Street 1:411B N. SALEM AVENUE
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29151
Practice Address - Country:US
Practice Address - Phone:803-774-2103
Practice Address - Fax:803-774-2105
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC199352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3337Medicare ID - Type Unspecified
SC376241Medicare ID - Type Unspecified
SC376241Medicare ID - Type Unspecified