Andrew L. Marcus, M.D.,P.C.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

AM042540 Issued in MI

Legal business name

ANDREW L. MARCUS, M.D.,P.C.

Practice address

3815 Pelham St
Suite 14
Dearborn, MI 48124-3852

Phone

(313) 730-9100

Fax

(313) 730-9104

NPI assigned

Apr 22, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Andrew L Marcus, M.D.

Title

Owner

Phone

(313) 730-9100

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1104090083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 PELHAM ST",
            "address_2": "SUITE 14",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243852",
            "telephone_number": "313-730-9100",
            "fax_number": "313-730-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 PELHAM ST",
            "address_2": "SUITE 14",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243852",
            "telephone_number": "313-730-9100",
            "fax_number": "313-730-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW L. MARCUS, M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "MARCUS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-730-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "AM042540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298636210",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "130823449",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.