Healthcare Provider Details

I. General information

NPI: 1033026281
Provider Name (Legal Business Name): MARCUS SAYLOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 LINCOLNWAY E
MISHAWAKA IN
46544-2016
US

IV. Provider business mailing address

1315 E 3RD ST
MISHAWAKA IN
46544-2730
US

V. Phone/Fax

Practice location:
  • Phone: 574-314-5987
  • Fax: 574-217-7954
Mailing address:
  • Phone: 269-270-6966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: