Provider Demographics
NPI:1013075951
Name:MARCUS, JOHN W (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
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 1:819 GLENN AVE
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33972-3331
Mailing Address - Country:US
Mailing Address - Phone:201-755-0544
Mailing Address - Fax:
Practice Address - Street 1:819 GLENN AVE
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33972-3331
Practice Address - Country:US
Practice Address - Phone:201-755-0544
Practice Address - Fax:201-447-3560
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06283200207V00000X
FLME155859207V00000X
NJMAC6232207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ737914Medicare ID - Type Unspecified
F53406Medicare UPIN