Provider Demographics
NPI:1063477404
Name:EIGG, MARC H (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:H
Last Name:EIGG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX 668
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-671-6790
Mailing Address - Fax:
Practice Address - Street 1:1682 EMPIRE BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580
Practice Address - Country:US
Practice Address - Phone:585-671-6790
Practice Address - Fax:585-671-1931
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192743-1207V00000X, 207VF0040X
NY192743207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG31484Medicare UPIN
NYCC6534Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION