Provider Demographics
NPI:1063608362
Name:ALAN J MARCUS DO PA
Entity type:Organization
Organization Name:ALAN J MARCUS DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-845-0833
Mailing Address - Street 1:750 OCEAN ROYALE WAY APT 1102
Mailing Address - Street 2:
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-1340
Mailing Address - Country:US
Mailing Address - Phone:561-845-0833
Mailing Address - Fax:561-863-5432
Practice Address - Street 1:415 US HIGHWAY 1 STE D
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-3585
Practice Address - Country:US
Practice Address - Phone:561-845-8333
Practice Address - Fax:561-863-5432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8406Medicare PIN