MEDICARE: DR. MARC KATTELMAN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	C2-0006894	DE

General Provider Information

NPI Number	:	1104821198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC KATTELMAN D.O.

Provider Business Mailing Address
First Line	:	40 SYCAMORE ST
Second Line	:
City	:	OCEAN VIEW
State	:	DE
Zip	:	19970-3217
Country	:	US
Telephone Number	:	302-537-5966
Fax Number	:

Provider Business Practice Location Address
First Line	:	RR 5 BOX 79
Second Line	:
City	:	SELBYVILLE
State	:	DE
Zip	:	19975-9706
Country	:	US
Telephone Number	:	302-436-9600
Fax Number	:	302-436-6260

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/08/2007

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