Provider Demographics
NPI:1013014612
Name:MARCUS, WALTER M (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:M
Last Name:MARCUS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8945 MAGNOLIA AVE
Mailing Address - Street 2:#202
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503
Mailing Address - Country:US
Mailing Address - Phone:951-687-8945
Mailing Address - Fax:951-687-1042
Practice Address - Street 1:8945 MAGNOLIA AVE
Practice Address - Street 2:#202
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503
Practice Address - Country:US
Practice Address - Phone:951-687-8945
Practice Address - Fax:951-687-1042
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG37441207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G377410Medicaid
G374410Medicare ID - Type Unspecified
CA00G377410Medicaid