Provider Demographics
NPI:1639203946
Name:JAIME F. MARQUEZ, M.D.,P.A.
Entity Type:Organization
Organization Name:JAIME F. MARQUEZ, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:FRANZ
Authorized Official - Last Name:MARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACS PA
Authorized Official - Phone:301-891-6040
Mailing Address - Street 1:7610 CARROLL AVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6384
Mailing Address - Country:US
Mailing Address - Phone:301-891-6040
Mailing Address - Fax:301-891-0730
Practice Address - Street 1:7610 CARROLL AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6384
Practice Address - Country:US
Practice Address - Phone:301-891-6040
Practice Address - Fax:301-891-0730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD26265174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01554J01Medicare ID - Type Unspecified
MDC88486Medicare UPIN