Basic Information
| Provider Information | |||||||||
| NPI: | 1891892352 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARCUS | ||||||||
| FirstName: | HILLARY | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 714 N. BETHLEHEM PIKE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | LOWER GWYNEDD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155404411 | ||||||||
| FaxNumber: | 2155404415 | ||||||||
| Practice Location | |||||||||
| Address1: | 714 N. BETHLEHEM PIKE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | LOWER GWYNEDD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155404411 | ||||||||
| FaxNumber: | 2155404415 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD428503 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 103027430 | 05 | PA | MEDICAID |