Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD428722 | PA |
Y | 208600000X | Surgeon | MD428722 | PA |
N | 2086S0102X | Surgical Critical Care | MD428722 | PA |
NPI | 1194934299 |
---|---|
Provider Name | Joshua Aaron Marks |
First Address | Philadelphia, PA 19107-5563 |
Second Address | Philadelphia, PA 19107-5563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 11/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0420611 | (05) | NJ |
102925388 | (05) | PA |