Provider Demographics
NPI:1962496042
Name:MARKS, STEVEN CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CRAIG
Last Name:MARKS
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 1:456 ALLIANCE ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-3559
Mailing Address - Country:US
Mailing Address - Phone:410-939-3933
Mailing Address - Fax:410-939-3934
Practice Address - Street 1:456 ALLIANCE ST
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-3559
Practice Address - Country:US
Practice Address - Phone:410-939-3933
Practice Address - Fax:410-939-3934
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD36768207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD511606600Medicaid
MDE54700Medicare UPIN
MD583FMedicare ID - Type Unspecified