Provider Demographics
NPI:1841556594
Name:MARCUS, REBECCA KATHLEEN (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:KATHLEEN
Last Name:MARCUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2508 MYRTLE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2700
Mailing Address - Country:US
Mailing Address - Phone:833-246-7662
Mailing Address - Fax:814-414-4896
Practice Address - Street 1:2508 MYRTLE ST STE 100
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2700
Practice Address - Country:US
Practice Address - Phone:833-246-7662
Practice Address - Fax:814-414-4896
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD478712208600000X
CAA168218208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery