Individual
SANFORD KENT MARCUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6601 MOORETOWN RD, SUITE 400, WILLIAMSBURG, VA 23188-2196
(757) 645-3150
Mailing address
860 OMNI BLVD, SUITE 303, NEWPORT NEWS, VA 23606-4430
(757) 232-8769
(757) 232-8875
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101227468
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005870411
—
VA
01
—
0403049
UNITED HEALTHCARE
VA
01
—
0410632001
CIGNA HEALTHCARE
VA
01
—
133641808
TRICARE
VA
01
—
29088
SENTARA/OPTIMA
VA
01
—
454080
ANTHEM BLUE CROSS BLUE SH
VA
01
—
P00315325
RR/MEDICARE
—
Enumeration date
02/22/2006
Last updated
10/05/2012
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