Provider Demographics
NPI:1043216104
Name:MARKOWICZ, ALLEN L (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:L
Last Name:MARKOWICZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 DORR ST # MS 840
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-4040
Mailing Address - Country:US
Mailing Address - Phone:419-214-4847
Mailing Address - Fax:567-661-0387
Practice Address - Street 1:1000 REGENCY CT STE 208
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3074
Practice Address - Country:US
Practice Address - Phone:419-214-4847
Practice Address - Fax:567-661-0387
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35033691 M207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0387648Medicaid
OH000000253204OtherANTHEM
OH0424715Medicare ID - Type Unspecified
OH000000253204OtherANTHEM