Provider Demographics
NPI:1467505198
Name:MARCHUK, YURI (MD)
Entity Type:Individual
Prefix:DR
First Name:YURI
Middle Name:
Last Name:MARCHUK
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 1:153 WILLIS RD
Mailing Address - Street 2:APT F
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4028
Mailing Address - Country:US
Mailing Address - Phone:302-359-7751
Mailing Address - Fax:
Practice Address - Street 1:240 BEISER BLVD
Practice Address - Street 2:#201 A
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-7790
Practice Address - Country:US
Practice Address - Phone:302-734-7246
Practice Address - Fax:302-678-8890
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00080452081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC1 0008045OtherDELAWARE STATE LICENSE
DEG00160Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER