Individual
MARILYN JOAN MACVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-5030
(215) 707-3494
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-5030
(215) 707-3494
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD037972E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018009850004
—
PA
01
—
0776587000
INDEPENDENCE BLUE CROSS
PA
01
—
791194
HIGHMARK BLUE SHIELD
PA
Enumeration date
03/14/2006
Last updated
03/21/2017
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