Provider Demographics
NPI:1417984626
Name:MARX, JASON (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:MARX
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 1:400 REDLAND COURT
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3292
Mailing Address - Country:US
Mailing Address - Phone:410-494-7921
Mailing Address - Fax:410-902-8247
Practice Address - Street 1:7505 OSLER DRIVE
Practice Address - Street 2:SUITE 409
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-321-5651
Practice Address - Fax:410-583-0134
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053464207RC0200X, 207RS0012X
MDD53464207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD70787506OtherBC/BS
MD0025OtherBS/BS
296005OtherRAILROAD MEDICARE
MD0025OtherBS/BS
MDK53146YYMedicare PIN