Provider Demographics
NPI:1336190248
Name:MARCALUS, ERIC CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:CHARLES
Last Name:MARCALUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3168 BRAVERTON ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-2674
Mailing Address - Country:US
Mailing Address - Phone:410-956-1600
Mailing Address - Fax:410-956-7900
Practice Address - Street 1:3168 BRAVERTON ST
Practice Address - Street 2:SUITE 250
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2674
Practice Address - Country:US
Practice Address - Phone:410-956-1600
Practice Address - Fax:410-956-7900
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2014-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD58166207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH63722Medicare UPIN
MD854RMedicare PIN