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PHILIP M MARDEN MD SC NPI 1700996576


NPI Information

NPI: 1700996576
Provider Name: PHILIP M MARDEN MD SC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
340 SUMMIT AVENUE
OCONOMOWOC, WI
ZIP 53066
Phone: (262) 567-0366
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PHILIP M MARDEN MD SC 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. PHILIP M MARDEN MD SC NPI is 1700996576. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

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

The provider's authorized official is Philip Manuel Marden .
The authorized official title is President and has the following contact phone number (262) 667-0366.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 12/6/2012.


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
1=========019OTHERBLUE CROSS AND COMPCARE
2B54821MEDICARE UPIN
3213688OTHERONE HEALTH PLAN
4MARDENPHIOTHERMERCYCARE HEALTH PLANS
5718112OTHERMANAGED HEALTH SERVICES
614664OTHERMEDICAL LICENSE
7W003437OTHERCHAMPUS
8112760524654OTHERHUMANA
952D0388538OTHERCLIA CERTIFICATE
104308968OTHERAETNA
11=========ZOOTHERUNITY HEALTH INSURANCE
121000283OTHERPHYSICIANS PLUS INSURANCE
131200110OTHERUNITED HEALTH CARE
1412659OTHERDEAN HEALTH PLAN
15=========AOTHERHUMANA
16AS68366510001OTHERCIGNA
1731212300MEDICAIDWISCONSIN

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.