Provider Demographics
NPI:1942254859
Name:ALBERNAZ, MARCUS S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:S
Last Name:ALBERNAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 JOHNS HOPKINS DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7222
Mailing Address - Country:US
Mailing Address - Phone:252-752-5227
Mailing Address - Fax:252-752-1191
Practice Address - Street 1:850 JOHNS HOPKINS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7222
Practice Address - Country:US
Practice Address - Phone:252-752-5227
Practice Address - Fax:252-752-1191
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC37784207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10476OtherBCBS
NC7910476Medicaid
NCE10602Medicare UPIN
NC213975Medicare ID - Type UnspecifiedMEDICARE