Provider Demographics
NPI:1477156909
Name:MARCOS, GEORGE NADER BISHAY
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:NADER BISHAY
Last Name:MARCOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 40TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3372
Mailing Address - Country:US
Mailing Address - Phone:202-396-2331
Mailing Address - Fax:
Practice Address - Street 1:320 40TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3372
Practice Address - Country:US
Practice Address - Phone:202-396-2331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH100002817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist