Healthcare Provider Details

I. General information

NPI: 1730217928
Provider Name (Legal Business Name): STEPHEN CRAIG MARCUM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 MEDICAL CENTER BLVD SUITE 1400
WEBSTER TX
77598-4052
US

IV. Provider business mailing address

1015 W MEDICAL CENTER BLVD STE 1400
WEBSTER TX
77598-4055
US

V. Phone/Fax

Practice location:
  • Phone: 281-338-2861
  • Fax: 281-554-2035
Mailing address:
  • Phone: 281-338-2861
  • Fax: 281-554-2035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG9983
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: