MEDICARE: REBECCA KATHLEEN MARCUS MD

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	208600000X	Surgery Physician	MD478712	PA

General Provider Information

NPI Number	:	1841556594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA KATHLEEN MARCUS MD

Provider Business Mailing Address
First Line	:	2508 MYRTLE ST STE 100
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16502-2700
Country	:	US
Telephone Number	:	833-246-7662
Fax Number	:	814-414-4896

Provider Business Practice Location Address
First Line	:	2508 MYRTLE ST STE 100
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16502-2700
Country	:	US
Telephone Number	:	833-246-7662
Fax Number	:	814-414-4896

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

Provider Enumeration Date	:	04/06/2012
Last Update Date	:	10/04/2022

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