Provider Demographics
NPI:1174631634
Name:MARCUS, STEVEN J (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:J
Last Name:MARCUS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:1420 N ASTOR ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2845
Mailing Address - Country:US
Mailing Address - Phone:414-224-7922
Mailing Address - Fax:414-271-9900
Practice Address - Street 1:3701 E EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7402
Practice Address - Country:US
Practice Address - Phone:920-739-7855
Practice Address - Fax:920-739-7856
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI9985040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist