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General NPI Number Information
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NPI Number | 1295933992
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Entity Type | Individual
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Provider Name | LEIGH JESSICA MARCUS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 N WOLFE ST CMSC 800
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City | BALTIMORE
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State | MD
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Zip | 21287-0005
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Country | US
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Telephone | 410-614-5055
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Fax |
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Provider Business Mailing Address
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Address Line | 14730 FOURTH STREET APT 442
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City | LAUREL
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State | MD
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Zip | 20707-3749
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Country | US
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Telephone | 240-786-7243
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 0450889
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License Number State | CT
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