Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MD031686E | PA |
NPI | 1003880071 |
---|---|
Provider Name | Donald K. Marcus |
First Address | Southampton, PA 18966-6008 |
Second Address | Southampton, PA 18966 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 18/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0011534700001 | (05) | PA |
E64070 | (02) | PA |