Provider Demographics
NPI:1285687558
Name:MARKS, HAROLD GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:GEORGE
Last Name:MARKS
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:ERIE AVE AT FRONG ST
Mailing Address - Street 2:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-1095
Mailing Address - Country:US
Mailing Address - Phone:215-427-5464
Mailing Address - Fax:
Practice Address - Street 1:ST CHRISTOPHER'S HOSPITAL FO
Practice Address - Street 2:ERIE AVENUE AT FRONT STREET
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-1095
Practice Address - Country:US
Practice Address - Phone:215-427-5464
Practice Address - Fax:215-427-4393
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020702E2080P0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012010590007Medicaid
PA046357Medicare ID - Type Unspecified
PAF04113Medicare UPIN