Provider Demographics
NPI:1285903609
Name:TOSHICH, MARKO (MD)
Entity type:Individual
Prefix:DR
First Name:MARKO
Middle Name:
Last Name:TOSHICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MARKO
Other - Middle Name:
Other - Last Name:TOSIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2790 GODWIN BLVD STE 360
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8153
Mailing Address - Country:US
Mailing Address - Phone:757-934-4821
Mailing Address - Fax:
Practice Address - Street 1:2800 GODWIN BLVD FL 1
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8038
Practice Address - Country:US
Practice Address - Phone:757-934-4821
Practice Address - Fax:757-934-4276
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101256937207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine