Provider Demographics
NPI:1942200084
Name:MARCHUK, JEROME M (MD)
Entity Type:Individual
Prefix:DR
First Name:JEROME
Middle Name:M
Last Name:MARCHUK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13 HAYWOOD OFFICE PARK
Mailing Address - Street 2:STE 106
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28785-6998
Mailing Address - Country:US
Mailing Address - Phone:828-452-5042
Mailing Address - Fax:828-452-9225
Practice Address - Street 1:98 DOCTORS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-4501
Practice Address - Country:US
Practice Address - Phone:828-631-8755
Practice Address - Fax:828-631-8777
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2016-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC18800208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC138M4OtherBCBS-IND.
NC89138M4Medicaid
NC89138M4Medicaid
NCC85312Medicare UPIN