Provider Demographics
NPI:1952412694
Name:MALBERG, MARC I (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:I
Last Name:MALBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1527 STATE HIGHWAY 27
Mailing Address - Street 2:STE 1300
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873
Mailing Address - Country:US
Mailing Address - Phone:732-249-4444
Mailing Address - Fax:732-249-6528
Practice Address - Street 1:1527 STATE HIGHWAY 27
Practice Address - Street 2:STE 1300
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-249-4444
Practice Address - Fax:732-249-6528
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03090600207XS0114X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1330501Medicaid
NJCC8492Medicare PIN
NJ186165Medicare ID - Type Unspecified
NJ1330501Medicaid