| Doctor Name: | DR. MARLENA NICOLE MATTINGLY |
| NPI Number: | 1023304847 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 11015972A |
| Business Practice Address: | 550 University Blvd Dept Of Obstetrics-gynecology Indianapolis, IN - 462025149 |
| Business Phone Number: | 3179485923 |
| Business Fax Number: | |
| Mailing Address: | Client Id 900011, Po Box 100106 COLUMBIA |
| State: | SC |
| Postal Code: | 29202 |
| Phone Number: | 8435227088 |
| Fax Number: | 8435225671 |
| NPI Enumeration Date: | 06/20/2011 |
| NPI Last Update Date: | 07/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | 11015972A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |