PHILIP M MARDEN MD SC (NPI# 1073652525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073652525 |
| Entity Type | Organization |
| Organization Name | PHILIP M MARDEN MD SC |
| Practice Address |
123 Hospital Drive Suite 212 Watertown WI 53098-3336 |
| Practice Telephone | 9202613898 |
| Practice Fax Number | 2625670368 |
| Mailing Telephone | 9202613898 |
| Mailing Fax Number | 2625670368 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2012-12-06 |
| Authorized Official Name | PHILIP M MARDEN (PRESIDENT) |
| Authorized Official Telephone | 2625670366 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
14664 | WI | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 14664 | WI | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 14664 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PHYSICIANS PLUS INSURANCE | 1000283 | 01 | |
| HUMANA | 112760524654 | 01 | |
| UNITED HEALTHCARE | 1200110 | 01 | |
| MANAGED HEALTH SERVICES | 718112 | 01 | |
| WI | ST OF WIS MEDICAL LICENSE | 14664 | 01 |
| MERCYCARE HEALTH PLANS | MARDENPHI | 01 | |
| ONE HEALTH PLAN | 213688 | 01 | |
| WI | 31212300 | 05 | |
| AETNA | 4308968 | 01 | |
| CHAMPUS | W003437 | 01 | |
| DEAN HEALTH PLAN | 12659 | 01 | |
| CIGNA | AS68366510001 | 01 | |
| CLIA CERTIFICATE | 52D0388538 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700996576 | Philip M Marden Md Sc | Allergy & Immunology | 340 Summit Avenue, Oconomowoc, WI 53066-3747 | 2006-08-30 |
| Street Address |
123 HOSPITAL DRIVE SUITE 212 |
| City | WATERTOWN |
| State | WI |
| Zip Code | 53098-3336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730156431 | Mohamed H Yafai | Internal Medicine | 123 Hospital Drive, Suite 2009, Watertown, WI 53098 | 2006-03-02 |
| 1992023493 | Sheila Kerri Sullivan | Ophthalmology | 123 Hospital Drive, Suite 1002, Watertown, WI 53098-3320 | 2010-05-07 |
| 1801981279 | Watertown Urology, S.c. | Urology | 123 Hospital Drive, Suite 2002, Watertown, WI 53098 | 2006-10-03 |
| 1548285273 | Peggy Burr | Physician Assistant | 123 Hospital Drive, Suite 2004, Watertown, WI 53098 | 2006-07-13 |
| 1942260518 | Eye Physicians of Watertown Sc | Optometrist | 123 Hospital Drive, Suite 1002, Watertown, WI 53098 | 2006-03-27 |
| 1639139074 | Holly C Van Hecke | Ophthalmology | 123 Hospital Drive, Suite 1002, Watertown, WI 53098 | 2006-03-27 |
| 1932177862 | Central Otologic Ltd | Otolaryngology | 123 Hospital Drive, Ste 106, Watertown, WI 53098 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528558749 | Watertown Physician Practices LLC | Eyewear Supplier (Equipment, not the service) | 123 Hospital Dr Ste 2005, Watertown, WI 53098 | 2018-05-14 |
| 1851822076 | Fort Health Care Inc | Otolaryngology | 123 Hospital Dr Suite 106a, Watertown, WI 53098 | 2017-03-21 |
| 1598045692 | Bonnie Kay Peot | Licensed Practical Nurse | 1420 Wedgewood Drive, Watertown, WI 53098 | 2011-08-19 |
| 1275790404 | Kathy R. Adkins | Physical Therapy Assistant | 1020 Hill Street, Watertown, WI 53098 | 2008-05-16 |
| 1336361294 | Patrice Walter | Occupational Therapist | 125 Hospital Dr., Watertown, WI 53098 | 2007-05-02 |
| 1720161284 | Carolyn T Schneider-donley | Optometrist | 622 N. Church Street, Watertown, WI 53098 | 2006-10-20 |
| 1093711236 | Dana M. Fields | Physician Assistant | 134 Hospital Drive, Watertown, WI 53098 | 2005-06-22 |
| 1528560018 | Watertown Medical Center LLC | Psychiatric Unit | 125 Hospital Drive, Watertown, WI 53098 | 2018-03-01 |
| 1437544863 | Zachary Richardson | Internal Medicine | 125 Hospital Dr, Watertown, WI 53098 | 2015-04-02 |
| 1942699632 | Morgan Lange Hennes | Specialist/Technologist | 125 Hospital Dr, Watertown, WI 53098 | 2015-01-18 |
| Find all providers in zip 53098 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689715658 | Teresa M. Kohlenberg | Pediatrics | 93 Garfield St, Watertown, MA 02472-4914 | 2007-02-10 |
| 1861589384 | Child and Adolescent Health Associates | Pediatrics | 513 Washington Street, Watertown, NY 13601-4001 | 2006-10-06 |
| 1265474894 | Brigido C Calado | Pediatrics | 1532 Utah St, Watertown, WI 53094-6410 | 2006-06-11 |
| 1477593069 | Robert Dennis Bacsik | Pediatrics | 435 Harris Dr, Watertown, NY 13601-4205 | 2006-06-08 |
| 1811947393 | Mario Francisco Victoria | Pediatrics | 18969 Us Route 11, 5699 Outer Washington Street, Watertown, NY 13601-5320 | 2006-05-12 |
| 1396702882 | Craig E. Crismon | Pediatrics | 511 14th Ave Ne, Watertown, SD 57201-6811 | 2006-04-27 |
| 1457326803 | Aida M. Yavshayan | Pediatrics | 375 Mount Auburn St, Watertown, MA 02472 | 2006-02-21 |
| 1225034119 | Karie Ann Mantey | Pediatrics | 134 Hospital Dr, Watertown, WI 53098-3304 | 2005-06-24 |
| 1285241307 | Ahmad Chatila | Pediatrics | 20011 Summit View Blvd, Watertown, NY 13601-1996 | 2020-09-24 |
| 1437437043 | Stephanie Ann Oliva | Pediatrics | 18969 Us Route 11, Pediatric Associates of Watertown, Watertown, NY 13601-6329 | 2011-07-31 |
| Find all providers in WATERTOWN | ||||
Please comment or provide details below to improve the information on PHILIP M MARDEN MD SC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.