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DR. PHILIP M MARDEN MD NPI 1073659546


NPI Information

NPI: 1073659546
Provider Name: DR. PHILIP M MARDEN, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual

PECOS Registration: Yes

Address:
340 SUMMIT AVENUE
OCONOMOWOC, WI
ZIP 53066
Phone: (262) 567-0366
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DR. Philip M Marden, MD is a pediatrics in Oconomowoc, WI. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Philip M Marden, MD NPI is 1073659546. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

340 SUMMIT AVENUE
OCONOMOWOC, WI
ZIP 53066-747
Phone: (262) 567-0366
Fax: (262) 567-0368

The NPI 1073659546 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 12/5/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207KA0200XAllergy & ImmunologyAllergy14664WISCONSINNo
2207Q00000XFamily Medicine14664WISCONSINNo
3208000000XPediatrics14664WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
114664OTHERWISCONSINST OF WIS MEDICAL LICENSE
2B54821MEDICARE UPIN
3000068053MEDICARE ID-TYPE UNSPECIFIED
412659OTHERDEAN HEALTH PLAN
5W003437OTHERCHAMPUS
652D0388538OTHERCLIA CERTIFICATE
7AS68366510001OTHERCIGNA
8MARDENPHIOTHERMERCYCARE HEALTH PLANS
9213688OTHERONE HEALTH PLAN
10112760524654OTHERHUMANA
111200110OTHERUNITED HEALTHCARE
124308968OTHERAETNA
13718112OTHERMANAGED HEALTH SERVICES
141000283OTHERPHYSICIANS PLUS INSURANCE
1531212300MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.