Provider Demographics
NPI:1295771525
Name:MARGOLIS, MARC (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:MARGOLIS
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 1:3800 RESERVOIR RD NW
Mailing Address - Street 2:PHC BUILDING, 4TH FLOOR
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2113
Mailing Address - Country:US
Mailing Address - Phone:202-444-6985
Mailing Address - Fax:877-376-2421
Practice Address - Street 1:3800 RESERVOIR ROAD NW
Practice Address - Street 2:PHC BUILDING 4TH FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007
Practice Address - Country:US
Practice Address - Phone:202-295-0560
Practice Address - Fax:877-376-2421
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD31894208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC027272100Medicaid
DC2123359OtherMAMSI LIFE & HEALTH
MD61240601OtherCAREFIRST BLUESHIELD
DCJ449-0002OtherCAREFIRST BLUESHIELD
MD459303100Medicaid
MD838M460FMedicare PIN
DC2123359OtherMAMSI LIFE & HEALTH
DCJ449-0002OtherCAREFIRST BLUESHIELD