| Doctor Name: | DR. PHILIP M MARDEN |
| NPI Number: | 1073659546 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 14664 |
| Business Practice Address: | 340 Summit Avenue Oconomowoc, WI - 530663747 |
| Business Phone Number: | 2625670366 |
| Business Fax Number: | 2625670368 |
| Mailing Address: | 340 Summit Avenue, OCONOMOWOC |
| State: | WI |
| Postal Code: | 530663747 |
| Phone Number: | 2625670366 |
| Fax Number: | 2625670368 |
| NPI Enumeration Date: | 01/30/2007 |
| NPI Last Update Date: | 12/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207KA0200X |
| License Number: | 14664 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Allergy & Immunology |
| Taxonomy Specialization: | Allergy |
| Taxonomy Definition: | |