Healthcare Provider Details

I. General information

NPI: 1881616647
Provider Name (Legal Business Name): MADELINE ESTHER MARCUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 09/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 MIDDLEFORD RD
SEAFORD DE
19973-3636
US

IV. Provider business mailing address

1515 SPRINGFIELD DR
CHICO CA
95928-5995
US

V. Phone/Fax

Practice location:
  • Phone: 302-629-6611
  • Fax:
Mailing address:
  • Phone: 307-811-4405
  • Fax: 302-651-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberG079237
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberC10011062
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG079237
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: