Individual
DR. KEVIN W MARCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 7TH AVE N, ST PETERSBURG, FL 33705-1300
(727) 825-1100
Mailing address
PO BOX 919379, ORLANDO, FL 32891-9379
(844) 453-1406
(772) 621-3180
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
17134
ND
2085R0202X
Diagnostic Radiology Physician
2020039265
MO
2085R0202X
Diagnostic Radiology Physician
MC-179
GU
2085R0202X
Diagnostic Radiology Physician
Primary
ME110234
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003839900
—
FL
01
—
14F8G
FL BCBS
FL
01
—
FF900Z
FL MEDICARE
FL
01
—
P01049403
FL RAILROAD MEDICARE PTAN
FL
Enumeration date
10/16/2007
Last updated
09/23/2025
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