MEDICARE: ADE MARCUS

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
1	163W00000X	Registered Nurse	R18213	MD
2	374U00000X	Home Health Aide
3	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1427471093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADE MARCUS

Provider Business Mailing Address
First Line	:	PO BOX 26513
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21207-0313
Country	:	US
Telephone Number	:	443-629-9243
Fax Number	:

Provider Business Practice Location Address
First Line	:	5310 OLD COURT RD STE 105
Second Line	:
City	:	RANDALLSTOWN
State	:	MD
Zip	:	21133-5281
Country	:	US
Telephone Number	:	443-629-9243
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2014
Last Update Date	:	02/01/2014

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Directions to “ ADE MARCUS ” Practice Location

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