Provider Demographics
NPI:1992768972
Name:CESARI, MARC DANIEL (DC)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:DANIEL
Last Name:CESARI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 LAUREL BUSH RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6156
Mailing Address - Country:US
Mailing Address - Phone:410-569-5969
Mailing Address - Fax:410-569-4454
Practice Address - Street 1:15 FAIRWOOD CT
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3005
Practice Address - Country:US
Practice Address - Phone:410-569-5969
Practice Address - Fax:410-569-4454
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1064048OtherAMERICAN SPECIALTY HEALTH
MD1152395OtherAETNA HMO
MD2935165OtherAETNA PPO
MD537MN484Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL