Provider Demographics
NPI:1851352819
Name:MARQUEZ, ESTEBAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:ESTEBAN
Middle Name:A
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11025 DAYBREAK CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4500
Mailing Address - Country:US
Mailing Address - Phone:240-401-4483
Mailing Address - Fax:410-327-1693
Practice Address - Street 1:2323 ORLEANS ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-1020
Practice Address - Country:US
Practice Address - Phone:410-558-4747
Practice Address - Fax:410-732-0185
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD52191207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G93662Medicare UPIN