Provider Demographics
NPI:1073562245
Name:MARKOU, MICHAEL (DO PA)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:MARKOU
Suffix:
Gender:M
Credentials:DO PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1266 TURNER ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-5921
Mailing Address - Country:US
Mailing Address - Phone:727-446-0176
Mailing Address - Fax:727-442-0696
Practice Address - Street 1:1266 TURNER ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5921
Practice Address - Country:US
Practice Address - Phone:727-446-0176
Practice Address - Fax:727-442-0696
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOSOOO6358207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80885OtherBLUE CROSS BLUE SHIELD
FL228557OtherAMERIGROUP
FL251281500Medicaid
FL80885ZMedicare ID - Type Unspecified
FL251281500Medicaid