Healthcare Provider Details

I. General information

NPI: 1154316602
Provider Name (Legal Business Name): MARJORIE SAUL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1246 W CHESTER PIKE SUITE 308
WEST CHESTER PA
19382-5683
US

IV. Provider business mailing address

1246 W CHESTER PIKE SUITE 308
WEST CHESTER PA
19382-5683
US

V. Phone/Fax

Practice location:
  • Phone: 610-696-5771
  • Fax: 610-696-5922
Mailing address:
  • Phone: 610-696-5771
  • Fax: 610-696-5922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD023978E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberMD023978E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: