Individual
JULIE PETERSEN MARCINEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
702 PROFESSIONAL PARK DR STE 104, SUMMERSVILLE, WV 26651-2033
(304) 872-0089
Mailing address
702 PROFESSIONAL PARK, SUITE 104, SUMMERSVILLE, WV 26651
(304) 872-0089
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34012862
OH
207Q00000X
Family Medicine Physician
3508
WV
207Q00000X
Family Medicine Physician
DO034562
DC
207Q00000X
Family Medicine Physician
H0081197
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H596080
MEDICARE
OH
Enumeration date
04/01/2013
Last updated
04/10/2026
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