Individual
KENNETH E MARNOCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
253 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1501
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
(765) 448-8335
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01031076A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000202120
ANTHEM PROVIDER NUMBER
IN
05
—
100320630
—
IN
01
—
10825542
CAQH NUMBER
IN
01
—
156682
PHCS PID NUMBER
IN
Enumeration date
03/15/2006
Last updated
09/17/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us