Provider Demographics
NPI:1154376549
Name:COLMER, MARC E (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:E
Last Name:COLMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 NEPTUNE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4144
Mailing Address - Country:US
Mailing Address - Phone:732-775-5300
Mailing Address - Fax:732-988-7364
Practice Address - Street 1:444 NEPTUNE BLVD
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4144
Practice Address - Country:US
Practice Address - Phone:732-775-5300
Practice Address - Fax:732-988-7364
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 24726174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ137627Medicare ID - Type Unspecified