MEDICARE: DR. ROBERT DAVID MARCUS M.D.

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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	14840	GA

General Provider Information

NPI Number	:	1609959725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT DAVID MARCUS M.D.

Provider Business Mailing Address
First Line	:	8065 INNISBROOK CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-2088
Country	:	US
Telephone Number	:	706-565-0155
Fax Number	:

Provider Business Practice Location Address
First Line	:	8065 INNISBROOK CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-2088
Country	:	US
Telephone Number	:	706-565-0155
Fax Number	:

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/09/2007

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