Provider Demographics
NPI:1619991726
Name:MARX, JONATHAN K (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:K
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 1:7788 ELMWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2503
Mailing Address - Country:US
Mailing Address - Phone:973-769-3444
Mailing Address - Fax:
Practice Address - Street 1:7788 ELMWOOD RD
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2503
Practice Address - Country:US
Practice Address - Phone:973-769-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD647352085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKR80O388Medicare PIN