Provider Demographics
NPI:1841326550
Name:MARSH, LORALEE (MD)
Entity type:Individual
Prefix:DR
First Name:LORALEE
Middle Name:
Last Name:MARSH
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 1:8223 BRECKSVILLE ROAD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1371
Mailing Address - Country:US
Mailing Address - Phone:440-526-4426
Mailing Address - Fax:440-526-7961
Practice Address - Street 1:8223 BRECKSVILLE ROAD
Practice Address - Street 2:SUITE #1
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1371
Practice Address - Country:US
Practice Address - Phone:440-526-4426
Practice Address - Fax:440-526-7961
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350464272084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0671391Medicare ID - Type Unspecified
E76048Medicare UPIN