Provider Demographics
NPI:1952659260
Name:WALTER M MARCUS M D INC
Entity Type:Organization
Organization Name:WALTER M MARCUS M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-687-8945
Mailing Address - Street 1:8945 MAGNOLIA AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-4436
Mailing Address - Country:US
Mailing Address - Phone:951-687-8945
Mailing Address - Fax:951-687-1042
Practice Address - Street 1:8945 MAGNOLIA AVE
Practice Address - Street 2:STE 202
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-4436
Practice Address - Country:US
Practice Address - Phone:951-687-8945
Practice Address - Fax:951-687-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty