MEDICARE: DR. MICHAEL DAVID MARCUS D.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	1223G0001X	General Practice Dentistry	05319	MD

General Provider Information

NPI Number	:	1396740031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DAVID MARCUS D.M.D.

Provider Business Mailing Address
First Line	:	344 UNIVERSITY BLVD W
Second Line	:	STE 214
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-1970
Country	:	US
Telephone Number	:	301-681-2969
Fax Number	:

Provider Business Practice Location Address
First Line	:	344 UNIVERSITY BLVD W
Second Line	:	STE 214
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-1970
Country	:	US
Telephone Number	:	301-681-2969
Fax Number	:

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

Provider Enumeration Date	:	06/18/2005
Last Update Date	:	07/08/2007

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