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Individual

DR. MARISSA B WILCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3400 SPRUCE ST., 3 SILVERSTEIN BLDG., SUITE D, PHILADELPHIA, PA 19104-4206
(215) 662-6932
(617) 662-7899
Mailing address
3400 SPRUCE ST., 3 SILVERSTEIN SUITE D, PHILADELPHIA, PA 19104-4206
(215) 662-6932
(612) 662-7899

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
225632
MA
207RI0200X
Infectious Disease Physician
Primary
MD441111
PA

Other

Enumeration date
12/05/2005
Last updated
05/29/2012
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