Provider Demographics
NPI:1295740942
Name:MARKS, ERIC C (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:C
Last Name:MARKS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 LEE RD
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-2329
Mailing Address - Country:US
Mailing Address - Phone:302-235-2744
Mailing Address - Fax:
Practice Address - Street 1:550 STANTON CHRISTIANA RD
Practice Address - Street 2:SUITE 302
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2198
Practice Address - Country:US
Practice Address - Phone:302-365-5470
Practice Address - Fax:302-365-6167
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-000495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1295740942OtherNPI
DE263498733OtherTAX ID#
DEF1-0000495OtherCHIROPRACTIC LICENSE
DEB930T64Medicare UPIN
DE00B930T64Medicare PIN