Individual
SANFORD KENT MARCUSON
Active
Individual
SANFORD KENT MARCUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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