National Provider Identifier

Marc Immerman, M.D.

Marc Immerman, M.D. is listed in the NPPES registry with a primary specialty of General Practice Physician in Elmira, NY and a listed phone number of (607) 732-5646.

NPI 1417967712Elmira, NYGeneral Practice Physician

Profile Overview

NPI
1417967712
Provider Type
Individual
Primary Specialty
General Practice Physician
Enumeration Date
August 09, 2006
Last Updated
February 06, 2018

Practice Location

  • 1003 Walnut St
  • Elmira, NY 14901-1007

Phone: (607) 732-5646

Specialties

  • General Practice Physician (208D00000X)
  • Emergency Medicine Physician (207P00000X)
Full Record
NPI
1417967712
Entity Type
Individual
Last Name
Immerman
First Name
Marc
Credential
M.D.
Mailing Street Address
1003 Walnut St
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14901-1007
Mailing Country
US
Mailing Phone
(607) 732-5646
Mailing Fax
(607) 732-0373
Practice Street Address
1003 Walnut St
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14901-1007
Practice Country
US
Practice Phone
(607) 732-5646
Practice Fax
(607) 732-0373
Enumeration Date
August 09, 2006
Last Updated
February 06, 2018
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Physician (208D00000X), Emergency Medicine Physician (207P00000X)
Other Identifiers
000915192004 (NY, BCBS), 01144467 (NY)