Healthcare Provider Details

I. General information

NPI: 1285687558
Provider Name (Legal Business Name): HAROLD GEORGE MARKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST CHRISTOPHER'S HOSPITAL FO ERIE AVENUE AT FRONT STREET
PHILADELPHIA PA
19134-1095
US

IV. Provider business mailing address

ERIE AVE AT FRONG ST ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
PHILADELPHIA PA
19134-1095
US

V. Phone/Fax

Practice location:
  • Phone: 215-427-5464
  • Fax: 215-427-4393
Mailing address:
  • Phone: 215-427-5464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License NumberMD020702E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: