Provider Demographics
NPI:1962692061
Name:YOUNTZ, MARCUS R (MD)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:R
Last Name:YOUNTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:GREEN #567
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1650
Mailing Address - Country:US
Mailing Address - Phone:617-928-1500
Mailing Address - Fax:617-630-0860
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:GREEN #567
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:617-928-1500
Practice Address - Fax:617-630-0860
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2338682084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9073387OtherAETNA
MAAA150004OtherHARVARD PILGRIM
223130OtherTUFTS
MA3242845OtherCIGNA
001252501Medicare UPIN