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NPI Code Detail

MEDICARE: DR. PAUL J MARR MD

MEDICARE: DR. PAUL J MARR MD
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
1207QS0010XSports Medicine (Family Medicine) PhysicianBM7144607PA

General Provider Information

NPI Number : 1407854961
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL J MARR MD
Provider Business Mailing Address
First Line : 11 FAIRLANE RD
Second Line :
City : READING
State : PA
Zip : 19606-9567
Country : US
Telephone Number : 610-779-2663
Fax Number : 610-779-3367
Provider Business Practice Location Address
First Line : 11 FAIRLANE RD
Second Line :
City : READING
State : PA
Zip : 19606-9567
Country : US
Telephone Number : 610-779-2663
Fax Number : 610-779-3367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 04/19/2011

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