Provider Demographics
NPI:1346212594
Name:MARKS, JOHN H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:MARKS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:SUITE 330 LANKENAU MOB WEST
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-645-9093
Mailing Address - Fax:610-645-9476
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:SUITE 330 LANKENAU MOB WEST
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-645-9093
Practice Address - Fax:610-645-9476
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2015-10-21
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Provider Licenses
StateLicense IDTaxonomies
PAMD046073L208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G19601Medicare UPIN
G19601Medicare UPIN
PA0015563580007Medicaid