Provider Demographics
NPI:1982695102
Name:MARCUS, ALEXANDER (MD)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
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 1:10 NEW DRIFTWAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-4530
Mailing Address - Country:US
Mailing Address - Phone:781-545-9225
Mailing Address - Fax:781-545-8560
Practice Address - Street 1:10 NEW DRIFTWAY
Practice Address - Street 2:SUITE 201
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-4530
Practice Address - Country:US
Practice Address - Phone:781-545-9225
Practice Address - Fax:781-545-8560
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10862100208000000X
MA216979208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2028450Medicaid
216979OtherTUFTS
MA206711OtherHPHC
MAJ26476OtherBCBS
H25273Medicare UPIN
MAA35669Medicare ID - Type Unspecified