Provider Demographics
NPI:1326532235
Name:MARCUS, NATHAN JOSEPH (PA-C)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:JOSEPH
Last Name:MARCUS
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:4200 DAHLBERG DR STE 300
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4841
Mailing Address - Country:US
Mailing Address - Phone:763-820-7870
Mailing Address - Fax:763-520-7580
Practice Address - Street 1:1000 W 140TH ST UNIT 201
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337
Practice Address - Country:US
Practice Address - Phone:952-808-3000
Practice Address - Fax:952-808-3001
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2020-06-01
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Provider Licenses
StateLicense IDTaxonomies
MN12746363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant