Healthcare Provider Details

I. General information

NPI: 1285621094
Provider Name (Legal Business Name): CHARLES B MAREK JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4021 BAY DR
MIDDLE RIVER MD
21220-4036
US

IV. Provider business mailing address

9712 BELAIR RD SUITE 100
BALTIMORE MD
21236-1103
US

V. Phone/Fax

Practice location:
  • Phone: 410-916-4090
  • Fax:
Mailing address:
  • Phone: 410-256-3200
  • Fax: 440-529-2462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0013064
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: