Healthcare Provider Details

I. General information

NPI: 1013075951
Provider Name (Legal Business Name): JOHN W MARCUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17031 ESPANA CIR
PUNTA GORDA FL
33955-4450
US

IV. Provider business mailing address

17031 ESPANA CIR
PUNTA GORDA FL
33955-4450
US

V. Phone/Fax

Practice location:
  • Phone: 201-755-0544
  • Fax: 201-447-3560
Mailing address:
  • Phone: 201-755-0544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMAC6232
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME155859
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: