Healthcare Provider Details

I. General information

NPI: 1639250079
Provider Name (Legal Business Name): MARCIA A MECKLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

U S DEPT OF STATE M/MED/QI 2401 E STREET NW
WASHINGTON DC
20522-0102
US

IV. Provider business mailing address

U S DEPT OF STATE M/MED/QI 2401 E STREET NW
WASHINGTON DC
20522-0102
US

V. Phone/Fax

Practice location:
  • Phone: 202-663-1903
  • Fax:
Mailing address:
  • Phone: 202-663-1903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD042250-E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: