Healthcare Provider Details

I. General information

NPI: 1457440281
Provider Name (Legal Business Name): BELINDA ELAINE MARCUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 NEWNAN CROSSING BLVD E STE E
NEWNAN GA
30265-2408
US

IV. Provider business mailing address

5505 PEACHTREE DUNWOODY RD STE 370
ATLANTA GA
30342-1713
US

V. Phone/Fax

Practice location:
  • Phone: 770-400-7850
  • Fax:
Mailing address:
  • Phone: 770-538-1772
  • Fax: 770-538-1773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number048541
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number048541
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number048541
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: