| Marc Immerman, MD | |
|
1003 Walnut St, Elmira, NY 14901-1007 | |
| (607) 732-5646 | |
| (607) 732-0373 |
| Full Name | Marc Immerman |
|---|---|
| Gender | Male |
| Speciality | General Practice |
| Location | 1003 Walnut St, Elmira, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417967712 | NPI | - | NPPES |
| 000915192004 | Other | NY | BCBS |
| 01144467 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 174214 (New York) | Secondary |
| 208D00000X | General Practice | 174214 (New York) | Primary |
| Entity Name | Nes Medical Services Of New York Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215455191 PECOS PAC ID: 0840181392 Enrollment ID: O20040323001392 |
| Entity Name | Chemung-schuyler Counties Chapter, Nysarc, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174146401 PECOS PAC ID: 3577980622 Enrollment ID: O20200903000937 |
| Mailing Address | Practice Location Address |
|---|---|
| Marc Immerman, MD 1003 Walnut St, Elmira, NY 14901-1007 Ph: (607) 732-5646 | Marc Immerman, MD 1003 Walnut St, Elmira, NY 14901-1007 Ph: (607) 732-5646 |
Devin Craig Thompson, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 600 Roe Ave, Elmira, NY 14905 Phone: 646-260-7977 | |
Rodrick Ducroix Coaxum, MD General Practice Medicare: Medicare Enrolled Practice Location: 600 Roe Ave, Elmira, NY 14905 Phone: 607-737-4100 |