Myron M Marlett, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

21501 Issued in WI

Practice address

2845 Greenbrier Rd Ste 240
Green Bay, WI 54311-6519

Phone

(920) 288-8280

Fax

(920) 288-8385

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Baycare Clinic LLP

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1134490758
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219968000000",
    "number": "1740226265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD STE 240",
            "address_2": "PO BOX 890",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543088900",
            "telephone_number": "920-288-8280",
            "fax_number": "920-288-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD STE 240",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-8280",
            "fax_number": "920-288-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLETT",
        "first_name": "MYRON",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2008-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "21501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "340015993",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30180200",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104384598",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3402100582",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Anne Marien
• Mark Brodhagen DDS SC
• Holli J Marklein, RN
• Victoria Marie Markowski, MS, ATR, LPC-IT
• Marla Vista Manor Assisted Living of Green Bay, LLC
• Kim Marohl, MA, LPC
• Patti M Marquardt, APNP
• Melissa S Marquart-Carlson, PHD
• Kara S Marquart, PA-C
• Marriage & Family Therapy Center

• Urology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Urology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.