Healthcare Provider Details

I. General information

NPI: 1952469983
Provider Name (Legal Business Name): ROBERT ELLIS MARKISON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 VAN NESS AVENUE SUITE 204
SAN FRANCISCO CA
94109-3017
US

IV. Provider business mailing address

2000 VAN NESS AVENUE SUITE 204
SAN FRANCISCO CA
94109-3017
US

V. Phone/Fax

Practice location:
  • Phone: 415-929-5900
  • Fax: 415-929-5909
Mailing address:
  • Phone: 415-929-5900
  • Fax: 415-929-5909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberG33051
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: