Provider Demographics
NPI:1952469983
Name:MARKISON, ROBERT ELLIS (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ELLIS
Last Name:MARKISON
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 1:2000 VAN NESS AVENUE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3017
Mailing Address - Country:US
Mailing Address - Phone:415-929-5900
Mailing Address - Fax:415-929-5909
Practice Address - Street 1:2000 VAN NESS AVENUE
Practice Address - Street 2:SUITE 204
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3017
Practice Address - Country:US
Practice Address - Phone:415-929-5900
Practice Address - Fax:415-929-5909
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG330512086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
A45399Medicare UPIN
00G33051Medicare ID - Type Unspecified