MEDICARE: DR. JOHNATHON TOMA MARKUS 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	390200000X	Student in an Organized Health Care Education/Training Program
2	208M00000X	Hospitalist Physician	4301106661	MI

General Provider Information

NPI Number	:	1548521461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHNATHON TOMA MARKUS M.D.

Provider Business Mailing Address
First Line	:	2128 RHINE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-3065
Country	:	US
Telephone Number	:	248-892-4675
Fax Number	:

Provider Business Practice Location Address
First Line	:	37399 GARFIELD RD STE 104
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48036-3672
Country	:	US
Telephone Number	:	586-569-3379
Fax Number	:	586-576-6264

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

Provider Enumeration Date	:	06/06/2012
Last Update Date	:	04/23/2019

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