MEDICARE: MARC A EXILUS

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	L8-0010236	DE

General Provider Information

NPI Number	:	1588149587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC A EXILUS

Provider Business Mailing Address
First Line	:	1423 CAPITOL TRL STE 1110
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19711-5709
Country	:	US
Telephone Number	:	302-722-4740
Fax Number	:

Provider Business Practice Location Address
First Line	:	1423 CAPITOL TRL STE 1110
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19711-5709
Country	:	US
Telephone Number	:	302-722-4740
Fax Number	:	302-722-4750

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

Provider Enumeration Date	:	09/26/2018
Last Update Date	:	07/11/2023

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Directions to “ MARC A EXILUS ” Practice Location

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