Marissa B Wilck, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

MD441111 Issued in PA

Practice address

3400 Spruce St.
3 Silverstein BLDG., Suite D
Philadelphia, PA 19104-4206

Phone

(215) 662-6932

Fax

(617) 662-7899

NPI assigned

Dec 5, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Penn - Medical Group

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1093725145
  NPD (past)
• Brigham and Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1235157769

  Infectious Disease

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1669456596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST.",
            "address_2": "3 SILVERSTEIN SUITE D",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6932",
            "fax_number": "612-662-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST.",
            "address_2": "3 SILVERSTEIN BLDG., SUITE D",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6932",
            "fax_number": "617-662-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCK",
        "first_name": "MARISSA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MA",
            "license": "225632",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MD441111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven C Wilbraham, MD
• Wilbur W Oaks MD & Associates PC
• Daniel Wilbur
• Samuel S Wilburn, DNP, AGNP
• Mary Lynn Wilby, MSN, CRNP
• Paula Wilcox-Pendleton, FNP-C
• Cammie Wilcox
• Eric L Wilcox
• Lisa Jean Wilcox
• Nicholas Son Wilcox

• Infectious Disease Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Infectious Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.