Provider Demographics
NPI:1831155811
Name:MARCUS, ANDREW J (DO)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:MARCUS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LAUREL MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:CENTRE HALL
Mailing Address - State:PA
Mailing Address - Zip Code:16828-7818
Mailing Address - Country:US
Mailing Address - Phone:814-404-6255
Mailing Address - Fax:
Practice Address - Street 1:105 LAUREL MEADOW LN
Practice Address - Street 2:
Practice Address - City:CENTRE HALL
Practice Address - State:PA
Practice Address - Zip Code:16828-7818
Practice Address - Country:US
Practice Address - Phone:814-404-6255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4779207X00000X
WV2164207X00000X
PAOS007480L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ324542Medicaid
AZ324542Medicaid
WVG09674Medicare UPIN