Provider Demographics
NPI:1649446121
Name:KINSEY, MARSHALL DEAN (MD)
Entity type:Individual
Prefix:
First Name:MARSHALL
Middle Name:DEAN
Last Name:KINSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 NEW ALBANY RD
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-1318
Mailing Address - Country:US
Mailing Address - Phone:856-235-3174
Mailing Address - Fax:856-802-1721
Practice Address - Street 1:501 NEW ALBANY RD
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-1318
Practice Address - Country:US
Practice Address - Phone:856-235-3174
Practice Address - Fax:856-802-1721
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02490600207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA02490600OtherNEW JERSEY MEDICAL LICENSE #
NJD00948000OtherNJ CDS #
NJD00948000OtherNJ CDS #