Provider Demographics
NPI:1386848752
Name:MARKLE, BRIAN JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JEFFREY
Last Name:MARKLE
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 1:44555 WOODWARD AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5031
Mailing Address - Country:US
Mailing Address - Phone:248-858-3878
Mailing Address - Fax:248-209-6777
Practice Address - Street 1:44555 WOODWARD AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5031
Practice Address - Country:US
Practice Address - Phone:248-858-3878
Practice Address - Fax:248-209-6777
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
IL125-050265207R00000X
MI4301091849207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine