Provider Demographics
NPI:1962450825
Name:SCHERTZER, MARION E (MD)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:E
Last Name:SCHERTZER
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 1:1505 NORTHSIDE BLVD 2900
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-8209
Mailing Address - Country:US
Mailing Address - Phone:770-277-4277
Mailing Address - Fax:
Practice Address - Street 1:5445 MERIDIAN MARKS RD STE 180
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4755
Practice Address - Country:US
Practice Address - Phone:770-277-4277
Practice Address - Fax:404-252-5745
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA037361208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00557983AMedicaid
519503OtherAETNA HMO
140001OtherUNITED HEALTHCARE
52451918OtherBCBS
1288OtherKAISER
0320530009OtherCIGNA HMO
4338334OtherAETNA NON HMO
0320530009OtherCIGNA HMO
4338334OtherAETNA NON HMO
519503OtherAETNA HMO