Healthcare Provider Details

I. General information

NPI: 1841228699
Provider Name (Legal Business Name): CAROL LYNNE MARSH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALAN SPENCER MILLINER MD

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 COPE ROAD SUITE E
KENNETT SQUARE PA
19348
US

IV. Provider business mailing address

630 COPE ROAD SUITE E
KENNETT SQUARE PA
19348
US

V. Phone/Fax

Practice location:
  • Phone: 610-444-5573
  • Fax: 610-444-0991
Mailing address:
  • Phone: 610-444-5573
  • Fax: 610-444-0991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD021384E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC10004171
License Number StateDE

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0026249000
Identifier TypeOTHER
Identifier State
Identifier IssuerPERSONAL CHOICE
# 2
Identifier2321461560002
Identifier TypeOTHER
Identifier State
Identifier IssuerCIGNA
# 3
Identifier99341
Identifier TypeOTHER
Identifier State
Identifier IssuerHEALTH ASSURANCE PENN INC
# 4
Identifier0182426
Identifier TypeOTHER
Identifier State
Identifier IssuerAETNA
# 5
Identifier99341
Identifier TypeOTHER
Identifier StateDE
Identifier IssuerCOVENTRY HEALTH CARE
# 6
Identifier99341
Identifier TypeOTHER
Identifier State
Identifier IssuerHEALTH AMERICA
# 7
Identifier288943
Identifier TypeOTHER
Identifier State
Identifier IssuerMAMSI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: