Provider Demographics
NPI:1104896877
Name:KRESS, MARC M (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:M
Last Name:KRESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:610 OLD YORK RD
Mailing Address - Street 2:SUITE 70
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2837
Mailing Address - Country:US
Mailing Address - Phone:215-887-3100
Mailing Address - Fax:215-572-3946
Practice Address - Street 1:610 OLD YORK RD
Practice Address - Street 2:SUITE 70
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2837
Practice Address - Country:US
Practice Address - Phone:215-887-3100
Practice Address - Fax:215-572-3946
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD027244E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA108104Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
B36732Medicare UPIN
PA691163Medicare ID - Type UnspecifiedGROUP NUMBER