Provider Demographics
NPI:1689678583
Name:MARCUS, BARRY (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:MARCUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10210 N 92ND ST
Mailing Address - Street 2:STE 201
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4524
Mailing Address - Country:US
Mailing Address - Phone:480-551-0388
Mailing Address - Fax:480-767-3846
Practice Address - Street 1:10210 N 92ND ST
Practice Address - Street 2:STE 201
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4524
Practice Address - Country:US
Practice Address - Phone:480-551-0388
Practice Address - Fax:480-767-3846
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ113382080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ069931Medicaid
AZE97735Medicare UPIN
AZ069931Medicaid