MEDICARE: DR. ROSE CORINNE 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	2080P0206X	Pediatric Gastroenterology Physician	2010-01138	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639260243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSE CORINNE MARCUS M.D.

Provider Business Mailing Address
First Line	:	333 SOUTH COLUMBIA STREET CAMPUS BOX 7229
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-7229
Country	:	US
Telephone Number	:	919-966-2435
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 SOUTH COLUMBIA STREET CB 7229
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-4202
Country	:	US
Telephone Number	:	919-966-2435
Fax Number	:

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/21/2022

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