Provider Demographics
NPI:1235235847
Name:MARCUS, ELLIOT LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:LEE
Last Name:MARCUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:333 WHITESPORT DR SW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6454
Mailing Address - Country:US
Mailing Address - Phone:256-880-0450
Mailing Address - Fax:256-880-0754
Practice Address - Street 1:333 WHITESPORT DR SW
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6454
Practice Address - Country:US
Practice Address - Phone:256-880-0450
Practice Address - Fax:256-880-0754
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL5049207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
630641282OtherMAILHANDLERS
AL630641282OtherFIRST COMMUNITY
AL51020200003920OtherBCBS
630641282OtherUNITED HEALTHCARE
CIGNAOther630641282
XXXXX1282358010000OtherWPS TRICARE
0004378719OtherAETNA
630641282OtherMAILHANDLERS
0004378719OtherAETNA