Provider Demographics
NPI:1104178789
Name:MAKOUS, MARINA V (MD)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:V
Last Name:MAKOUS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:430 EXTON COMMONS
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341
Mailing Address - Country:US
Mailing Address - Phone:484-876-1362
Mailing Address - Fax:610-363-6131
Practice Address - Street 1:430 EXTON COMMONS
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341
Practice Address - Country:US
Practice Address - Phone:484-876-1362
Practice Address - Fax:610-363-6131
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY271443207Q00000X
PAMD047146L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine