Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 31425 | IA |
NPI | 1023090057 |
---|---|
Provider Name | Richard H Marcus |
First Address | Des Moines, IA 50306-9170 |
Second Address | West Des Moines, IA 50266-8209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 14/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0139675 | (05) | IA |
060039705 | RR MEDICARE (01) | IA |
CS9044 | RR MEDICARE GROUP NUMBER (01) | IA |
F30688 | (02) | IA |