Provider Demographics
NPI:1932193240
Name:ALPERT, MARC H (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:H
Last Name:ALPERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:91 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848
Mailing Address - Country:US
Mailing Address - Phone:570-268-4713
Mailing Address - Fax:570-268-4716
Practice Address - Street 1:37 PRATT AVE
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848
Practice Address - Country:US
Practice Address - Phone:570-268-4713
Practice Address - Fax:570-268-4716
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032226E208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA160804Y0LMedicare PIN
PAC32350Medicare UPIN