Dr. Philip M Marden
Pediatrician Family Doctor Allergist
340 Summit Avenue
Oconomowoc
, Wisconsin 53066-3747
Dr. Philip M Marden
Pediatrician Family Doctor Allergist
340 Summit Avenue
Oconomowoc
, Wisconsin 53066-3747
(262) 567-0368
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About
Features
Specialties
- Allergist
- Family Doctor
- Pediatrician
Languages spoken
- English
Location
First Address
- Dr. Philip M Marden
- 340 Summit Avenue
- Oconomowoc, WI
- Zip : 53066-3747
- Fax : (262) 567-0368
- Phone : (262) 567-0366
Second Address
- Dr. Philip M Marden
- 340 Summit Avenue
- Oconomowoc, WI
- Zip : 53066-3747
- Fax : (262) 567-0368
- Phone : (262) 567-0366
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Is Dr. Philip M Marden a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207KA0200X | Allergist | 14664 | WI |
| N | 207Q00000X | Family Doctor | 14664 | WI |
| Y | 208000000X | Pediatrician | 14664 | WI |
National Provider Identifier
| NPI | 1073659546 |
|---|---|
| Provider Name | Dr. Philip M Marden |
| First Address | Oconomowoc, WI 53066-3747 |
| Second Address | Oconomowoc, WI 53066-3747 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/01/2007 |
| Last Update Date | 05/12/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1000283 | PHYSICIANS PLUS INSURANCE (01) | |
| 112760524654 | HUMANA (01) | |
| 1200110 | UNITED HEALTHCARE (01) | |
| 12659 | DEAN HEALTH PLAN (01) | |
| 14664 | ST OF WIS MEDICAL LICENSE (01) | WI |
| 213688 | ONE HEALTH PLAN (01) | |
| 31212300 | (05) | WI |
| 4308968 | AETNA (01) | |
| 52D0388538 | CLIA CERTIFICATE (01) | |
| 718112 | MANAGED HEALTH SERVICES (01) | |
| AS68366510001 | CIGNA (01) | |
| B54821 | (02) | |
| MARDENPHI | MERCYCARE HEALTH PLANS (01) | |
| W003437 | CHAMPUS (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.