Healthcare Provider Details

I. General information

NPI: 1790883031
Provider Name (Legal Business Name): MARCUS INSTITUTE FOR DEVELOPMENT AND LEARNING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 BRIARCLIFF RD NE
ATLANTA GA
30329-4010
US

IV. Provider business mailing address

2931 E BIDDLE ST PATIENT ACCOUNTING - HELENA PORTER
BALTIMORE MD
21213-3939
US

V. Phone/Fax

Practice location:
  • Phone: 404-419-4000
  • Fax: 404-419-4505
Mailing address:
  • Phone: 443-923-1886
  • Fax: 443-923-1875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL J NEUMAN
Title or Position: VICE PRESIDENT - FINANCE
Credential:
Phone: 443-923-1810