Provider Demographics
NPI:1881648509
Name:MARCUM, AUBREY L (MPAS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AUBREY
Middle Name:L
Last Name:MARCUM
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1208
Mailing Address - Country:US
Mailing Address - Phone:419-420-0904
Mailing Address - Fax:419-420-1893
Practice Address - Street 1:1917 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1208
Practice Address - Country:US
Practice Address - Phone:419-420-0904
Practice Address - Fax:419-420-1893
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2061363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBL9335631Medicare ID - Type Unspecified