Individual
MARILYN F WITHERUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
701 E 16TH ST, BERWICK, PA 18603-2316
(570) 759-5250
(570) 759-5522
Mailing address
137 DEEP DRIFT DR, BLOOMSBURG, PA 17815-6805
(570) 784-6820
(570) 784-6820
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD012835E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001086289
—
PA
Enumeration date
03/14/2006
Last updated
07/03/2008
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