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NPI Code Detail

MEDICARE: DR. FRED MARKUS DDS

MEDICARE:  DR. FRED  MARKUS  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist12586MO

General Provider Information

NPI Number : 1093889610
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRED MARKUS DDS
Provider Business Mailing Address
First Line : 10 CLAYTON TER
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63131-2920
Country : US
Telephone Number : 314-839-2347
Fax Number : 314-994-9483
Provider Business Practice Location Address
First Line : 11115 NEW HALLS FERRY RD
Second Line : SUITE 104
City : FLORISSANT
State : MO
Zip : 63033-7613
Country : US
Telephone Number : 314-839-2347
Fax Number : 314-839-3360
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 07/08/2007

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Directions to “ DR. FRED MARKUS DDS” Practice Location

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