Provider Demographics
NPI:1720582273
Name:PEREZ, MARLA MARIA (MD)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:MARIA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 ALLENDALE ROAD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406
Mailing Address - Country:US
Mailing Address - Phone:239-595-8181
Mailing Address - Fax:
Practice Address - Street 1:777 TOWNSHIP LINE ROAD
Practice Address - Street 2:SUITE 150
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5567
Practice Address - Country:US
Practice Address - Phone:239-595-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4746642085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology