Healthcare Provider Details

I. General information

NPI: 1669432977
Provider Name (Legal Business Name): ERIC ALAN MARCHANT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 05/26/2020
Certification Date: 05/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 W STATE ST
DOYLESTOWN PA
18901
US

IV. Provider business mailing address

P O BOX 829641
PHILADELPHIA PA
19182-0001
US

V. Phone/Fax

Practice location:
  • Phone: 267-885-1775
  • Fax: 267-885-1757
Mailing address:
  • Phone: 267-370-5296
  • Fax: 215-230-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD38631-E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD038631-E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: