Provider Demographics
NPI:1033329586
Name:MARCUS, ROBERT LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:MARCUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 3907
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-0807
Mailing Address - Country:US
Mailing Address - Phone:410-285-8787
Mailing Address - Fax:410-282-3579
Practice Address - Street 1:1576 MERRITT BLVD
Practice Address - Street 2:SUITE 15
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21222-2132
Practice Address - Country:US
Practice Address - Phone:410-285-8787
Practice Address - Fax:410-282-3579
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0006997207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD76285Medicare UPIN
MD5673Medicare ID - Type Unspecified