Provider Demographics
NPI:1588939961
Name:COUEY, MARCUS AARON (MD)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:AARON
Last Name:COUEY
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 1:100 E NEWTON ST STE 446
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3552
Mailing Address - Country:US
Mailing Address - Phone:617-414-4046
Mailing Address - Fax:
Practice Address - Street 1:1849 NW KEARNEY ST STE 300
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1453
Practice Address - Country:US
Practice Address - Phone:503-983-7334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-18
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD193416204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery