Provider Demographics
NPI:1952319493
Name:MARCUS, RANDALL E (MD)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:E
Last Name:MARCUS
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 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVENUE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-844-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-039984207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0639965OtherAETNA
OH000000503678OtherANTHEM
OH000000221366OtherUNISON
OH0463798Medicaid
OH363803OtherWELLCARE
OHP00011023OtherRAILROAD MEDICARE
OH738075OtherBUCKEYE
OHP00399414OtherRAILROAD MEDICARE
OH000000503678OtherANTHEM
OH363803OtherWELLCARE
OHMA4170981Medicare PIN