Individual
BRIAN MARCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 E CHESTNUT ST, STE. 303, LOUISVILLE, KY 40202-1831
(502) 629-5552
(502) 629-3132
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01062113A
IN
207Q00000X
Family Medicine Physician
Primary
39534
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
082480
SIHO NORTON ICC
KY
05
—
200858020
—
IN
01
—
P00415225
RAILROAD MEDICARE-NORTON
KY
Enumeration date
09/20/2006
Last updated
09/23/2022
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