Provider Demographics
NPI:1790746907
Name:MARCOUX, J PAUL II (MD)
Entity Type:Individual
Prefix:
First Name:J PAUL
Middle Name:
Last Name:MARCOUX
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:450 BROOKLINE AVE
Mailing Address - Street 2:DANA FARBER CANCER INSTITUTE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5418
Mailing Address - Country:US
Mailing Address - Phone:617-632-3468
Mailing Address - Fax:617-632-5786
Practice Address - Street 1:450 BROOKLINE AVE
Practice Address - Street 2:DANA FARBER CANCER INSTITUTE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5418
Practice Address - Country:US
Practice Address - Phone:617-632-3468
Practice Address - Fax:617-632-5786
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2014-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA73616207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ10672OtherBLUE CROSS BLUE SHIELD
MA3074064Medicaid
9497OtherHPHC DFCI ONLY
65554OtherFALLON COMMUNITY HEALTH P
073616OtherTUFTS
4884121OtherCIGNA
MAJ10672OtherBLUE CROSS BLUE SHIELD
4884121OtherCIGNA