Provider Demographics
NPI:1689632507
Name:MARKUNS, KIMBERLY A (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:MARKUNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3867
Mailing Address - Country:US
Mailing Address - Phone:978-463-1303
Mailing Address - Fax:978-463-1360
Practice Address - Street 1:25 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3867
Practice Address - Country:US
Practice Address - Phone:978-463-1303
Practice Address - Fax:978-463-1360
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA160842207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA101422OtherPILGRIM HEALTH
MA3200574Medicaid
MS000000047365OtherBMC HEALTHNET
MA407479OtherTUFTS
MAJ21320OtherBCBS
MAJ21320OtherBCBS
MA407479OtherTUFTS
MAA2986001Medicare PIN