| Marley Medical Provider Group, P.a. | |
|
2134 W Lawn Ave Madison WI 53711-1950 | |
| (415) 390-6008 | |
| Not Available |
| Full Name | Marley Medical Provider Group, P.a. |
|---|---|
| Speciality | General Practice |
| Location | 2134 W Lawn Ave, Madison, Wisconsin |
| Authorized Official Name and Position | Sibel Sayiner (CSO) |
| Authorized Official Contact | 4153906008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marley Medical Provider Group, P.a. 2858 University Ave # 266 Madison WI 53705-3644 Ph: () - | Marley Medical Provider Group, P.a. 2134 W Lawn Ave Madison WI 53711-1950 Ph: (415) 390-6008 |
| NPI Number | 1487301917 |
|---|---|
| Provider Enumeration Date | 03/04/2022 |
| Last Update Date | 08/25/2023 |
| Medicare PECOS PAC ID | 8022472026 |
|---|---|
| Medicare Enrollment ID | O20230908003087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487301917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Rachel Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497715635 PECOS PAC ID: 0840285177 Enrollment ID: I20230908003237 |
| Provider Name | Amanda Marie Simone-belin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427444249 PECOS PAC ID: 2961751029 Enrollment ID: I20230913002526 |
| Provider Name | Kristina Bartelt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447619010 PECOS PAC ID: 3375849508 Enrollment ID: I20231219002336 |
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