Provider Demographics
NPI:1639260243
Name:MARCUS, ROSE CORINNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:CORINNE
Last Name:MARCUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROSE
Other - Middle Name:CORINNE
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:333 SOUTH COLUMBIA STREET CAMPUS BOX 7229
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7229
Mailing Address - Country:US
Mailing Address - Phone:919-966-2435
Mailing Address - Fax:
Practice Address - Street 1:333 SOUTH COLUMBIA STREET CB 7229
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-4202
Practice Address - Country:US
Practice Address - Phone:919-966-2435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-011382080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0111830Medicaid
PA1016950960001Medicaid