Provider Demographics
NPI:1861429342
Name:GARNICK, MARC B (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:B
Last Name:GARNICK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:330 BROOKLINE AVENUE
Mailing Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER - SHAPIRO CLINICAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5419
Mailing Address - Country:US
Mailing Address - Phone:617-667-5288
Mailing Address - Fax:617-975-5665
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-5288
Practice Address - Fax:617-975-5665
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA39022207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0115622Medicaid
MAA67041Medicare UPIN