Provider Demographics
NPI:1164491775
Name:MARKHAM, RAYMOND E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:E
Last Name:MARKHAM
Suffix:JR
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 1:1900 BROTHER GEENEN WAY
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-7102
Mailing Address - Country:US
Mailing Address - Phone:941-556-3220
Mailing Address - Fax:941-955-8214
Practice Address - Street 1:1900 BROTHER GEENEN WAY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-7102
Practice Address - Country:US
Practice Address - Phone:941-556-3220
Practice Address - Fax:941-955-8214
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031621A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100138510Medicaid
IN222750CMedicare PIN
IN100138510Medicaid
P00220831Medicare PIN
IN151560N5Medicare PIN