MEDICARE: JOHN D MARQUARDT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	131494-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	200041061	OTHER	NY	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P101131494	OTHER	NY	CROSSBRIDGE PHYSICIANS
3	102282	OTHER	NM	PREFERRED CARE
4	RC60131494	OTHER	NY	RCIPA, INC.
5	5010331	OTHER	NY	AETNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	P010131494	OTHER	NY	EXCELLUS BC BS

General Provider Information

NPI Number	:	1215903562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN D MARQUARDT M.D.

Provider Business Mailing Address
First Line	:	125 LATTIMORE RD
Second Line	:	SUITE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14620-4159
Country	:	US
Telephone Number	:	585-473-1033
Fax Number	:	585-473-8605

Provider Business Practice Location Address
First Line	:	125 LATTIMORE RD
Second Line	:	SUITE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14620-4159
Country	:	US
Telephone Number	:	585-473-1033
Fax Number	:	585-473-8605

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	12/08/2009

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Directions to “ JOHN D MARQUARDT M.D.” Practice Location

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