Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD469563 | PA |
NPI | 1053705962 |
---|---|
Provider Name | Dr. Marcus James Magister |
First Address | Winston Salem, NC 27157-0001 |
Second Address | Washington, PA 15301-9408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2015 |
Last Update Date | 24/06/2020 |