Provider Demographics
NPI:1437367182
Name:MARKS, MARIA MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:MICHELLE
Last Name:MARKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 INVERNESS CENTER DR
Practice Address - Street 2:SUITE A
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-4834
Practice Address - Country:US
Practice Address - Phone:205-995-5575
Practice Address - Fax:205-995-5576
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28345207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology