Individual
DR. JAMES G MARENCIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 339-8109
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 337-2438
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01051630
IN
2084P0804X
Child & Adolescent Psychiatry Physician
01051630
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200261970A
—
IN
Enumeration date
12/07/2005
Last updated
06/17/2019
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